DOI: 10.61873/rcpp.40.e207786

Authors: Martín Roberto Basile-Alvarez, Erick André Escalante-Buendía, Karen A. Palacios-Aguirre, Alejandro Ortega Desio, Omar Yaxmehen Bello-Chavolla

Abstract: To evaluate current therapies for diabetic macular edema (DME), with emphasis on durability, safety, access, and the evidence supporting aflibercept 8 mg. An expert-selected narrative synthesis of primary clinical trials, pharmacologic studies, regulatory documents, and selected real-world evidence published from January 1, 2000, through August 8, 2026, was performed. Anti-vascular endothelial growth factor therapy remains first-line treatment for most center-involved DME with visual impairment, but observation or focal/grid laser is reasonable for selected eyes with good visual acuity. In PHOTON, aflibercept 8 mg every 12 or 16 weeks after three monthly doses was noninferior to aflibercept 2 mg every 8 weeks for visual acuity at week 48; durability and similar safety were maintained through week 96 with fewer injections. Faricimab, brolucizumab, dexamethasone and fluocinolone implants, and the ranibizumab Port Delivery System offer alternative durability profiles with distinct evidence and risks. Aflibercept 8 mg provides an effective option for extending treatment intervals while maintaining visual and anatomical outcomes; however, no single therapeutic strategy is optimal for all patients. Treatment should therefore be individualized according to visual and anatomical response, ocular and systemic characteristics, patient preference, treatment burden, access, and local health-system constraints.

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DOI: 10.61873/rcpp.40.e196749

Authors: Arbind Kumar Choudhary

Abstract: Background: Gastroesophageal reflux disease (GERD) is a prevalent chronic acid-related disorder that substantially impairs patient quality of life. Proton pump inhibitors (PPIs) are established therapy; however, first-generation agents such as omeprazole show clinically relevant inter-individual variability related in part to cytochrome P450 2C19 (CYP2C19) metabolism. Ilaprazole, a newer PPI with predominant cytochrome P450 3A4 (CYP3A4) metabolism and a longer elimination half-life, may provide more consistent acid suppression, but direct comparative data in Indian patients with GERD and erosive gastritis using validated quality-of-life tools remain limited. Aim: To compare the clinical efficacy, health-related quality-of-life outcomes, and safety of ilaprazole 10 mg once daily versus omeprazole 20 mg once daily over eight weeks in patients with symptomatic GERD and endoscopically confirmed erosive gastritis. Erosive esophagitis was not required for inclusion and was not the primary condition studied. Methodology: A prospective, single-center, single-blind, comparative clinical study was conducted at VMKVMC&H, Salem, Tamil Nadu. Sixty patients fulfilling the inclusion criteria were randomly assigned in a 1:1 ratio to either ilaprazole 10 mg (n=30) or omeprazole 20 mg (n=30) once daily before breakfast for eight weeks. Participants were blinded to treatment allocation, while treating investigators were aware of allocation for dispensing and safety monitoring. Primary outcomes were change in GERD symptom count and health-related quality of life assessed using the 25-item QOLRAD questionnaire across five domains: Emotional distress, sleep disturbance, food/drink problems, physical/social functioning, and vitality. The theoretical QOLRAD total score range is 25-175, with higher scores indicating better quality of life. Adverse drug reactions, adherence, and concomitant/rescue medication use were assessed at follow-up visits. Baseline imbalances in symptom count and choking sensation were taken into account when analysing efficacy outcomes. Results: The groups were comparable in age (35.8±6.3 vs 37.2±4.8 years; p=0.352), and sex distribution was similar but not identical (male 53.3% vs 50.0%; p=1.000). Baseline QOLRAD total scores were comparable (34.07±9.10 vs 33.13±7.73; p=0.965). Baseline symptom count was higher in the omeprazole group (7.90±0.61 vs 7.10±0.96; p<0.001), and choking sensation was present only in the omeprazole group (36.7% vs 0%); therefore, we analysed symptom-count findings with caution, focusing on change from baseline. By week 8, ilaprazole was associated with a higher QOLRAD total score than omeprazole (146.57±4.14 vs 103.63±32.26; p<0.001; Cohen's d=1.706; mean difference 42.94, 95% CI 30.81-55.07). Mean GERD symptom count declined from 7.10±0.96 to 0.67±0.48 with ilaprazole (90.6% reduction) versus 7.90±0.61 to 3.10±1.18 with omeprazole (60.8% reduction). At week 8, ilaprazole showed higher point-in-time symptom resolution for epigastric pain, nausea, irritating throat sensation, belching, and loss of appetite. The week 4-to-week 8 nausea pattern was clarified as point-in-time symptom status, because symptoms could recur or be re-reported at the final visit. Adverse drug reactions were mild and comparable between groups (10.0% vs 13.3%; p>0.05), with no serious adverse events in either arm. Conclusion: Ilaprazole 10 mg once daily was associated with greater improvement in GERD symptom burden and health-related quality of life than omeprazole 20 mg once daily over eight weeks, with a comparable safety profile. However, because this was a small, single-center, single-blind study with baseline symptom imbalance and without CYP genotyping, pharmacokinetic assessment, intragastric pH monitoring, or repeat endoscopy, we regard these findings as preliminary and requiring confirmation in larger, methodologically rigorous trials. Pharmacogenomic and pharmacological explanations should be regarded as plausible hypotheses rather than proven mechanisms.

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DOI: 10.61873/rcpp.40.e198855

Authors: Charalambos Dokos, Despoina Koulenti

Abstract: Antimicrobial resistance (AMR) poses a significant global health challenge, and antimicrobial stewardship (AMS) initiatives are acknowledged as vital measures to enhance antibiotic utilization in healthcare facilities. Nevertheless, the effective execution of AMS programs continues to be exceptionally difficult across various healthcare environments. This opinion paper consolidates findings globally to pinpoint the primary obstacles and emerging viewpoints related to the implementation of hospital-based AMS. The analysis indicates that the challenges are complex, encompassing organizational, structural, cultural, educational, and behavioural aspects. Deficiencies in leadership and governance at various institutional tiers create a lack of accountability and commitment, while insufficient human and financial resources—including a shortage of infectious disease specialists, clinical pharmacists, and microbiologists—compromise the sustainability of these programs. Deeply rooted professional hierarchies and power dynamics among healthcare disciplines hinder interprofessional collaboration and diminish the acceptance of stewardship recommendations. Knowledge deficits and a lack of AMS-specific training across all professional categories further limit implementation, as do inadequate diagnostic laboratory capabilities and restricted health information technology. A persistent gap between national policies and local implementation realities leads to guidelines that are poorly suited to institutional contexts, while mandatory strategies may result in unintended outcomes such as regulatory evasion and decreased motivation among healthcare workers. These challenges are intensified in low- and middle-income countries but remain significant even in well-resourced environments. Promising strategies encompass multidisciplinary team approaches, governmentled accountability frameworks, contextualized implementation plans, and expanded roles for healthcare professionals.

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DOI: 10.61873/rcpp.40.e190445

Authors: Nikolaos Dogkas, Maria Trapali, Christine Fountzoula, George Albert Karikas, Petros Karkalousos

Abstract: Background: Adipose tissue is an active endocrine organ responsible for the production of adipokines. Aim: This study aimed to investigate whether serum levels of four adipokines (leptin, adiponectin, resistin, visfatin) and lipid parameters (cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol) are affected by adjuvant chemotherapy. Methodology: Twenty-five Greek patients who had been operated and received adjuvant chemotherapy with a good response were included. Blood samples were collected at three distinct time points during treatment, in order to mesure the above parameters. Results: Cholesterol, LDL and HDL levels did not show statistically significant differences at the three time points. In contrast, triglycerides were statistically significant higher (p=0.0030) at the final time point. Serum leptin and resistin levels prior to treatment were significantly higher (p<0.0001) than those observed during mid- and end-treatment. Comparison between the mid- and end- treatment time points showed a statistically significant difference (p<0.0001), with higher levels observed at the mid-treatment time point. Serum adiponectin lev-els yielded a significant difference (lower value) between the baseline and the end time points (p<0.0001), as well as across the other time points. Visfatin levels were significantly higher at the baseline of the treatment compared to both mid- and end-treatment levels (both p<0.0001). Conclusion: Increased levels of adiponectin, together with decreased values of the other three adipokines, are consistent with the results from previous studies, suggesting their potential use as auxiliary parameters. Regarding lipids, only levels of triglycerides provide relevant information. However, due to the absence of a control group and the small sample size (n=25), these findings should be interpreted as exploratory and hypothesis-generating rather than confirmatory.

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DOI: 10.61873/rcpp.40.e181965

Authors: Frosyna Anagnosti, Anna Bilali, Aleksandros Dourakis, Aikaterini Alexiou, Evanthia Douraki, Kiriaki Gatanas, Pinelopi Stamati, Theano Tsakmaki, Dimitra Darahani

Abstract: Background: Healthcare professionals involved in adverse events may experience the Second Victim Phenomenon (SVP), leading to emotional distress, burnout, and turnover intention. Nurses are particularly vulnerable due to their close involvement in patient care. Aim: To systematically review measurement tools and organizational support approaches used to assess and address the Second Victim Phenomenon in nurses and healthcare professionals. Methodology: A PRISMA-guided systematic review was conducted using PubMed, Scopus, and the Cochrane Library. Primary studies published in English between January 2017 and October 2025 were screened using predefined inclusion and exclusion criteria. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results: Ten studies met the inclusion criteria. Validated measurement instruments, including the SeViD questionnaire and the Second Victim Experience and Support Tool (SVEST), were identified. Organizational approaches such as peer-support and tiered intervention models (e.g., RISE, forYOU) were also described. SVP was consistently associated with psychological distress and turnover intention, while supportive organizational cultures facilitated coping. Conclusion: SVP is a common issue among nurses, and both measurement tools and organizational support approaches are important for identifying and managing its impact. However, the predominance of cross-sectional designs limits causal conclusions, highlighting the need for longitudinal and intervention-based research.

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DOI: 10.61873/jzpr9600

Authors: Kyriakoula Manaridou, Jost Eberlein, Olympia Konstantakopoulou, Alexandra Skitsou, Petros Galanis, Georgios Charalambous, Charalambos Dokos

Abstract: Background: Prescription errors (PE) in psychiatric hospitals can compromise treatment and patient safety. While well studied in general healthcare, evidence from psychiatric settings, particularly in Germany, remains scarce. Aim: This preliminary study investigates the prevalence, types, and severity of PE in a German psychiatric hospital over 12 months. Methodology: A prospective observational study was conducted at St. Josef AMEOS Psychiatric Hospital, Oberhausen, Germany (2023–2024). All 6,020 paper-based therapeutic plans were screened. From these, 150 cases of PE were identified for interim analysis. Errors were categorized using adapted EQUIP methodology and classified by severity (minor, major, serious, potentially fatal) and by drug group according to the British National Formulary (BNF). Results: Of the 150 cases, 93.3% were minor, 5.0% were major, and 1.7% were serious; no potentially fatal errors were observed. Writing errors were most common (38%). Errors most frequently involved musculoskeletal medications (BNF 10; 36.7%), followed by gastrointestinal (BNF 1; 18.7%) and CNS/psychotropics (BNF 4; 14.7%). Most errors occurred in inpatient settings and were primarily attributed to residents and consultants. Significant associations were found between error type and drug class, and between error type and severity (p<0.05). Conclusion: These interim results suggest that PE in psychiatric hospitals are mostly minor, with somatic medications more often affected than psychotropics. Given the small interim sample (150 of 6,020 plans), findings should be interpreted cautiously and considered hypothesis-generating. Larger, multi-center studies and evaluation of electronic prescribing systems are needed to confirm these patterns and guide interventions.

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DOI: 10.61873/sfjo4531

Authors: Apostolos Kolokythas, Maria Noula, Monica Nikitara, Zoe Roupa

Abstract: Background: Job satisfaction is a fundamental factor affecting nurse well-being, retention, and healthcare system performance. Aim: This study explores the determinants of job satisfaction among nurses, with particular emphasis on the differences between temporary agency nurses and those in permanent positions in North Rhine-Westphalia, Germany. Methodology: A cross-sectional study was conducted to assess job satisfaction among nurses working under both temporary agency and permanent employment contracts. Data were collected from a sample of 195 nurses using the Job Satisfaction Survey (JSS), a standardized instrument designed to measure multiple domains of job satisfaction. The survey included items related to supervision, salary, promotion opportunities, work relationships, and benefits. Statistical analyses were performed to identify and compare job satisfaction levels between the two employment groups. Results: Temporary nurses reported consistently higher satisfaction than permanent nurses across most domains of the Job Satisfaction Survey. Supervision was the most positively rated factor (97.9% of temporary vs. 72.2% of permanent nurses), while pay (73.0% vs. 11.1%) and benefits (51.8% vs. 9.3%) also showed large disparities. Promotion opportunities were rated lowest by both groups (7.1% vs. 3.7%), and satisfaction with co-worker relationships remained stable across groups (63.1% vs. 63.0%). The most pronounced contrast was observed in overall job satisfaction: 61.7% of temporary nurses reported being satisfied compared with only 5.6% of permanent nurses. Regression analysis confirmed that permanent employment was negatively associated with satisfaction, whereas higher educational attainment predicted higher satisfaction with pay and overall job satisfaction. Conclusion: The findings reveal significant and counterintuitive differences in job satisfaction between temporary and permanent nurses. Contrary to expectations, temporary nurses consistently reported higher satisfaction across most domains of work life. Addressing issues related to compensation, career progression, and job stability is essential to enhance satisfaction and reduce turnover. Healthcare organizations should implement targeted strategies that acknowledge the distinct needs of both employment groups and foster a supportive working environment.

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DOI: 10.61873/XWJX3729

Authors: Paraskevi Konstantinidi, Petros Papagiorgis, Nikolaos Thalassinos, Olympia Tzaida, Fragkiski Anthouli-Anagnostopoulou

Abstract: Background: Breast carcinoma is among the three most common types of cancer worldwide, including lung cancer and colon cancer, regardless of gender. The Bcl -2 oncogene is involved in a number of malignant neoplasms, includ­ing leukaemia and lymphoma, through the regulation of the cell apoptosis process. Aim: The main purpose of the present study is to investigate the association of Bcl-2 with other molecular parameters of significant prognostic and predictive value for disease and more specifically the ER and PR receptors, along with HER-2 and Ki-67 (MIB-1). Methodology: Immunohistochemical assessment of Bcl-2, ER and PR receptors, HER-2 and Ki-67 was conducted in a case series of 100 surgically resected primary breast carcinomas and the association of Bcl-2 with the other bi­omarkers was statistically investigated. Results: High (3+) Bcl-2 expression was observed in 65% of cases, moderate (2+) in 12%, low (1+) in 4% and negative expression in 19%. Association of Bcl-2 with ER-PR receptors and HER2 and Ki67 was conducted with Fisher’s exact and Chi square (x 2 ) test of Cramer’s V statistics tests were performed where appropriate. Bcl -2 oncogene was positively and highly associated with estrogen ER receptors (Phi=0.760, p =<0.0001); the findings of the association of Bcl -2 oncogene with PR progesterone receptors were similar: a positive association was found between the two specific biomarkers (Phi=0.626, p =<0.0001). Finally, negative association of Bcl-2 with HER2 (Phi=-0.350, p =<0.0001). Conclusion: Considering the association of Bcl-2 expression with the ex­pression of genes that are related to therapy prediction (ER and PR) it remains to be ascertained whether Bcl-2 could be used as a potential predictive marker. Moreover, the negative association of Bcl-2 with Ki67 and HER2 should be furthermore investigated for its association with disease outcome and response to targeted therapy. Overall, this study suggests that Bcl-2 should be further tested for its incorporation into a multivariate prediction model for breast cancer therapy. In addition, more investigations are required into targeted anti-Bcl-2 therapy may be used to modify re­sponses to current breast cancer therapy, in order to reduce resistance.

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DOI: 10.61873/HZPT7878

Authors: Kyriakoula Manaridou, Jost Eberlein, Olympia Konstantakopoulou, Alexandra Skitsou, Petros Galanis, Georgios Charalambous, Charalambos Dokos

Abstract: Background: Prescription errors in substitution therapy for addiction treatment, including opioid substitution therapy (OST) with methadone and buprenorphine and pharmacotherapy for alcohol use disorder (AUD) with naltrexone, acamprosate, and disulfiram, pose a critical patient safety issue. These errors are a major contributing factor to adverse drug events (ADEs), poor treatment adherence, discontinuation, and severe outcomes such as fatal overdoses. Additional factors such as miscommunication, inadequate training, and complex medication regimens exacerbate the risk. Aim: This systematic review aims to evaluate the prevalence, causes, and consequences of prescription errors in substitution therapy for addiction treatment. It explores the roles of healthcare professionals, system-level factors and their impact on patient safety, focusing on adherence, treatment outcomes, and ADEs. Methodology : A systematic search was conducted in PubMed, Scopus, and Google Scholar for studies published between January 2000 and July 2025. Studies addressing prescription errors in OST or AUD pharmacotherapy, including generic or therapeutic substitution, were included. Data on error types, prevalence, contributing factors, consequences, and interventions were extracted. Qualitative data underwent thematic analysis, while quantitative data were synthesized descriptively. Results: Prescription error rates in OST varied widely, from 1.7% in older adults to 30.3% in overdose reports, with methadone and buprenorphine implicated most frequently. Common errors included incorrect dosing, dispensing errors, and inadequate monitoring, leading to respiratory depression, overdose, and treatment failure. Key contributing factors were miscommunication, insufficient training, frequent formulary changes, and patient-related factors such as cognitive impairment. Pharmacist-led interventions, digital prescribing systems, and standardized protocols significantly reduced errors. Data on AUD pharmacotherapy errors were sparse, highlighting a critical research gap. Conclusion: Prescription errors in substitution therapy pose significant risks to patient safety, primarily due to systemic and human factors. Enhanced training, standardized protocols, and digital tools are effective mitigation strategies. Further research is needed to quantify errors in AUD pharmacotherapy and develop targeted interventions.

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DOI: 10.61873/OBAR5597

Authors: Paraskevi Konstantinidi, Petros Papagiorgis, Nikolaos Thalassinos, Olympia Tzaida, Fragkiski Anthouli-Anagnostopoulou

Abstract: Background : The Bcl-2 protein is a member of the bcl family of proteins, which play a key role in the cell apoptosis process. Its tumorigenic potential has been established long ago in animal experimental models, and was subse­quently supported by the finding of its overexpression in a variety of human tumours. Bcl-2 has been suggested as a prognostic marker for the neoplastic diseases; new evidence keeps arising providing further support to this finding. Aim : This study investigated the association of Bcl-2 expression with prognostically important clinicopathological fea­tures in breast carcinoma in the Greek population. Methodology : Immunohistochemical assessment of Bcl-2 was conducted in a case series of 100 surgically resected primary breast carcinomas from November 2022 to July 2023 and the association of Bcl-2 with the grade of histological differentiation and Lymph nodes pN was statistically inves­tigated. Results : The histological grade profile of the studied samples was: Grade III (24%), Grade II (62%), Grade I (14%). High (score 3+) Bcl-2 expression was found in 65% of cases, moderate (score 2+) expression in 12%, low (score 1+) in 4%, while negative expression was shown in 19% of the samples. A statistically significant inverse association between Bcl-2 expression and the grade of histological differentiation was detected (Phi=-0.850, p =< 0.0001). Bcl-2 expression was also inversely associated with Lymph nodes pN stage ( p =0.001). Conclusion : The observed association of immunohistochemical Bcl-2 expression with clinicopathological characteristics which are known prognositc indicators for breast cancer (grade and pN stage) provides confirmatory evidence to the potential important prognostic value of this marker in breast cancer. Future investigations should incorporate Bcl-2 expression in multivariate prediction models to weigh its value in the clinical management of breast cancer.

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DOI: 10.61873/MKUR2695

Authors: Alaa Alsajri, Walid Al-Qerem, Dzul Noor

Abstract: Background : Spirometric reference equations are essential for accurate interpretation of lung function tests. However, most globally used equations are derived from Western populations and may not reflect the physiological norms of Arab populations. Aim : To systematically evaluate the applicability of internationally adopted spirometric reference equations within Arab populations and to assess the availability of population-specific equations in the Arab world. Methodology : A systematic review was conducted using PubMed, Scopus, Google Scholar, and CORE databases for studies published up to July 2023. Studies were included if they developed, validated, or assessed spirometric reference equations in Arab populations. Out of 57 initially identified studies, 14 met the inclusion criteria. Results : Based on the 14 studies conducted, the majority of studies reported that predicted values for forced expiratory volume in one second (FEV₁) and forced vital capacity (FVC) in Arab populations were significantly lower than those predicted by equations derived from Western populations. This discrepancy suggests potential misclassification of respiratory diseases when non-local reference values are applied. Conclusion : The routine application of spirometric reference equations developed in Western populations may lead to inaccurate interpretation of lung function in Arab individuals. There is a clear need for developing standardized, population-specific reference equations that account for the ethnic and anthropometric characteristics of Arab populations to enhance diagnostic accuracy and clinical decision-making.

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DOI: 10.61873/MQCB4262

Authors: Marianna Marra, Stefanos Zervoudis, Vasiliki Michou, Panagiotis Eskitzis, George Iatrakis, George Mastorakos

Abstract: This review explores the complex relationship between thyroid function and menopause, focusing on physiological interactions, clinical implications, and diagnostic challenges associated with thyroid dysfunction in postmenopausal women. Drawing on recent studies and current understanding, it examines how menopausal hormonal changes influ­ence thyroid health, increasing the risk of conditions such as hypothyroidism, hyperthyroidism, and subclinical thyroid disorders. Overlapping symptoms, including mood changes, sleep disturbances, weight fluctuations, and reduced libido, complicate diagnosis, as they can be attributed to both menopause and thyroid dysfunction. Hormonal shifts can also impact bone mineral density, cardiovascular health, and metabolism, while prolonged estrogen exposure and surgical menopause are linked to an elevated risk of thyroid cancer. Diagnostic complexity is heightened by age-related changes, comorbidities, and potential interferences in thyroid function tests. Routine thyroid assessment is recommended for women with surgical menopause or other risk factors. Personalized management, including meno­pausal hormone therapy (MHT), can address overlapping symptoms and mitigate skeletal and cardiovascular risks. A patient-centred approach is crucial, with treatment tailored to individual health profiles. Further research is needed to clarify the interactions between menopause and thyroid function to improve clinical care.

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DOI: 10.61873/HJDS2975

Authors: Niki Tertipi, Eleni Sfyri

Abstract: The biophysical properties of the skin vary significantly across different racial and gender groups, influencing skin health, function, and response to environmental factors. This review explores the impact of race and gender on cutaneous biophysical properties, highlighting differences in skin structure, function, and response to environmental factors. The study synthesizes data from multiple sources to elucidate how genetic, hormonal, and environmental factors contribute to variations in skin properties across different racial and gender groups. Key findings suggest that melanin content, transepidermal water loss (TEWL), sebum production, and skin elasticity exhibit significant variability, impacting dermatological health and cosmetic product development. A comprehensive understanding of these variations can aid in the development of targeted dermatological treatments and skincare products tailored to specific demographic needs.

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DOI: 10.61873/CFEX1776

Authors: Niki Tertipi

Abstract: The biophysical properties of human skin, such as hydration, elasticity, sebum content, and transepidermal water loss (TEWL), are influenced by both age and body location. These factors play a critical role in dermatological health and the efficacy of skincare products. Aging is generally associated with decreased hydration, elasticity, and sebum production, while TEWL increases, indicating a decline in skin barrier function. Additionally, different anatomical locations exhibit distinct biophysical characteristics due to varying densities of sebaceous glands and exposure to environmental factors. For instance, sebaceous gland-rich areas like the forehead show higher sebum content, while the palms exhibit lower hydration levels. This review presents a comprehensive analysis of current research on the effects of age and body location on skin biophysical properties to guide future dermatological studies and skincare product development.

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DOI: 10.61873/BIND1188

Authors: Eleni Sfyri, Niki Tertipi

Abstract: Cellulite treatments vary in their mechanisms, invasiveness, and durability of outcomes. Non-invasive options, such as topical agents and oral supplements, provide moderate benefits but require prolonged use. Massage and energy-based therapies offer better cosmetic improvements but often require multiple sessions with results that may not be long-lasting. Invasive treatments, like subcision and injectable options, directly address structural issues underlying cellulite. The choice of treatment depends on individual patient needs, cellulite severity, and the desired balance between invasiveness and results. A tailored approach considering the underlying structural and aesthetic concerns often yields the best outcomes.

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DOI: 10.61873/VHXH4395

Authors: Eleni Sfyri

Abstract: Cellulite is a common dermatologic condition affecting 80-90% of post-pubertal females, particularly on the thighs, buttocks, and hips. It is characterized by dimpling and a “mattress-like” skin appearance, significantly impacting body image and quality of life. More prevalent in Caucasian women, it results from multifactorial causes, including hormonal influences (e.g., estrogen), structural differences in subcutaneous tissues, vascular changes, and low-grade inflammation. Lifestyle and aging further contribute to its severity. Treatments range from topical applications and energy-based devices to minimally invasive procedures, though results are often temporary. Due to its complex etiopathogenesis and structural changes, cellulite remains challenging to treat, necessitating realistic patient expectations and further research for improved and lasting solutions.

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DOI: 10.61873/JAYQ8271

Authors: Efstathios Rallis, Chrysovalantis Korfitis

Abstract: Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous reaction pattern commonly related to medication administration. The eruption is of sudden onset, accompanied by fever and it is characterized by the development of sterile miliary pustules over erythematous skin. To the best of our knowledge, we present the fourth case of AGEP induced by ciprofloxacin.

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DOI: 10.61873/CREL4322

Authors: George Koulierakis

Abstract: Expectations are beliefs or assumptions about future events; they allow individuals to be prepared and guide their behaviour when the anticipated situation occurs. Cognitive biases represent judgements about a situation which deviate from norm and rationality. Unrealistic optimism is the tendency for people to believe that a personal future outcome will be more favourable than that suggested by a relevant, objective standard. A growing number of individuals undergo into aesthetic interventions to their body, motivated by interpersonal and/or societal factors. Not all of these individuals are satisfied with the results of the interventions and the unrealistic expectations about the interventions is a contributing factor, alongside with other situational factors. Both clients and aesthetic professionals must be aware of their (unrealistic) expectations regarding aesthetic interventions I order to make the most appropriate decisions.

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DOI: 10.61873/HILP7973

Authors: Sophia Hatziantoniou, Vasiliki Kefala

Abstract: Local anesthetics play a crucial role in aesthetic procedures, offering temporary pain relief while preserving recipient’s consciousness. They are widely used in procedures such as laser treatments, injectable therapies, chemical peels, and microneedling. This review explores the mechanisms of action, pharmacokinetics, formulations, and safety considerations of these agents, emphasizing their influence on procedural outcomes and patient comfort. Local anesthetics work by inhibiting sodium ion channels, preventing nerve signal transmission. Their efficacy depends on factors like chemical composition, lipid solubility, pKa, and the tissue environment. Common formulations include creams, gels, patches, and sprays, each tailored to specific applications and procedural needs. Safety concerns, including systemic toxicity and allergic reactions, highlight the importance of appropriate dosing and formulation choice. Recent advancements, such as nanotechnology and enhanced delivery systems, promise to improve anesthetic performance and safety. This review underscores the indispensable role of local anesthetics in modern aesthetic practice.

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DOI: 10.61873/NMDM6216

Authors: Androniki Chante, Angeliki-Victoria Roussaki-Schulze

Abstract: Hirsutism is observed in 5-10% of women during their reproductive years and is a particularly distressing disorder that affects the quality of life of these women. Many studies have found the role of diet and lifestyle modification to be beneficial in managing non-communicable metabolic diseases; however, there is limited research on their role in hirsutism. Patients with hirsutism, in prevalence, exhibit insulin resistance, hyperinsulinemia, and hyperandrogenism (except for patients with Idiopathic hirsutism), while the majority of them are over-weight and obese. Dietary patterns, such as DASH, ketogenic, and intermittent fasting, have been studied for their positive effect on hirsutism.

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DOI: 10.61873/XSWZ8013

Authors: Foteini Biskanaki, Efstathios Rallis, Vasiliki Kefala

Abstract: Aging is the result of tissue energy alteration, therefore when an external energy source is applied, such as radiofrequency (RF), high-intensity focused ultrasound (HIFU), and/or their combination, it results in their renewal and improvement of skin aging. Nowadays, even for the most difficult parts such as the neck and décolleté, these modern non-invasive aesthetic technologies are applied with results from one treatment. The combination protocols will offer maximum results, if they are used under the right conditions.

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DOI: 10.61873/PJIX3890

Authors: Eleni Andreou, Efstathios Rallis, Vasiliki Kefala

Abstract: Permanent makeup (PMU) is a very popular application for the correction of facial imperfections. It can be applied over the face area to correct the characteristics such as the eyebrows, the eyelids and the lips. These applications are the most famous for permanent makeup. The change in shape and colour of eyebrows is most popular in contrast to the eyelids application to create permanent eyeliner shapes, and the lips application to create permanent lipliner and lip shading features. It also has a “medical” role when it is applied for mimicking hair follicles on the scalp area or breast areola reconstruction after mastectomy. These procedures can lead from minor to serious problems in skin condition from the first day of application, even months later. These un-wanted side effects are unpredictable factors that cannot be avoided. On the other hand, the extraordinary rising of the tattoo industry has raised the number of patients who want to “remove” their tattoo. The most common reason is changing their mind or wanting another design to decorate their body. Various ways of tattoo removal have been used for many years with laser removal to gain popularity. Unfortunately, laser tattoo removal has also many unwanted side effects that can lead to serious skin problems.

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DOI: 10.61873/RGHB5923

Authors: Shaymaa Abdul Zahra Ayoub, Noor H. Naser Aldabagh, Rana Atiya

Abstract: Background: A substantial number of thiazolidin-4-one derivatives have been shown to have a variety of pharmaco­logical characteristics.Aim: The current study seeks to design new acetazolamide products with thiazolidin-4-one moiety and evaluate their inhibitory effect to carbonic anhydrase XII enzyme (protein data bank code: 1JD0) and anti-cancer properties in silico. Four acetazolamide derivatives with a thiazolidin-4-one moiety will be produced using acetazolamide as the starting material.Methodology: The molecular docking studies were determined by utilizing the Molecular Operating Environment (MOE) software version 2015.10. The binding tendencies of docked ligands to the target protein carbonic anhydrase XII were described as root-mean-square deviation (RMSD) and standard score (S score).Results: The process of docking demonstrated that the four test ligands (IIIa, IIIb, IIIc, and IIId) had a higher binding affinity for the objective protein carbonic anhydrase XII than the reference ligand, which is an acetazolamide. Consid­ering the four compounds, the compound IIIa had the ultimate affinity of binding, and S score of -7.4.Conclusion: The findings imply that the designed acetazolamide compounds, specifically IIIa, have the potential to be carbonic anhydrase inhibitors and anti-cancer medicines that target the carbonic anhydrase XII enzyme.

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DOI: 10.61873/JYAN4719

Authors: Angeliki Sarella, Despoina Velli, Maria Kontoyannis, Eriketi Kokkosi, Maria Tzitiridou-Chatzopoulou, Eirini Orovou

Abstract: Background : The process of healing a dermatologic surgical wound is highly complex. Any disruption at any stage may lead to delayed closure, prolonged hospitalization, increased expenses, and adverse effects on patients’ daily routines. Aim : The primary objective of this clinical study was to assess the efficacy of postoperative interventions involving oral vitamin C or topical silicone gel, either independently or in combination, in the context of healing from dermatologic surgery trauma. Furthermore, the study sought to investigate the potential impact of inflammatory markers, such as IL-6 and CRP, as well as lifestyle interventions, specifically physical activity and smoking, on the healing process. Methodology : A prospective study was conducted from August 2017 to December 2021 at the Outpatient Dermatological Clinic in Tzaneio General Hospital in Greece to evaluate the effect of vitamin C, silicone gel, or the combination of both on small and medium-sized dermatological trauma healing. A total of 112 patients were included in the study; 29 patients had a natural postoperative healing, while 83 received oral vitamin C or topical silicone gel, or the combination of both. Scar Assessment Score and the Vancouver Scar Scale were used to evaluate the healing. Results : Patients treated with the combination of oral vitamin C and topical silicone gel experienced accelerated wound healing compared to the other treatment groups. Conclusion : Based on the research findings, it is concluded that the use of combined therapy involving oral administration of vitamin C and topical application of silicone gel accelerates the postoperative healing process in cases of dermatologic surgery trauma.

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DOI: 10.61873/QNCK7709

Authors: Eleftheria Tampouratzi, Ioannis Karavokyros, Stamatios Gregoriou, Petros Karkalousos, Charis Liapi

Abstract: Background : The process of healing a dermatologic surgical wound is highly complex. Any disruption at any stage may lead to delayed closure, prolonged hospitalization, increased expenses, and adverse effects on patients’ daily routines. Aim : The primary objective of this clinical study was to assess the efficacy of postoperative interventions involving oral vitamin C or topical silicone gel, either independently or in combination, in the context of healing from dermatologic surgery trauma. Furthermore, the study sought to investigate the potential impact of inflammatory markers, such as IL-6 and CRP, as well as lifestyle interventions, specifically physical activity and smoking, on the healing process. Methodology : A prospective study was conducted from August 2017 to December 2021 at the Outpatient Dermatological Clinic in Tzaneio General Hospital in Greece to evaluate the effect of vitamin C, silicone gel, or the combination of both on small and medium-sized dermatological trauma healing. A total of 112 patients were included in the study; 29 patients had a natural postoperative healing, while 83 received oral vitamin C or topical silicone gel, or the combination of both. Scar Assessment Score and the Vancouver Scar Scale were used to evaluate the healing. Results : Patients treated with the combination of oral vitamin C and topical silicone gel experienced accelerated wound healing compared to the other treatment groups. Conclusion : Based on the research findings, it is concluded that the use of combined therapy involving oral administration of vitamin C and topical application of silicone gel accelerates the postoperative healing process in cases of dermatologic surgery trauma.

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DOI: 10.61873/BBDF1129

Authors: Maria Trapali, Petros Karkalousos, Nikos Dogkas, George Karikas

Abstract: Background: Fibroblast growth factor 21 (FGF21 regulates several biochemical pathways such as glucose/fructose update, lipid oxidation, and insulin/glycogen sensitivity. Some beneficial effects of FGF21 on human body have been investigated, including weight loss and improved glycemia. It has been also suggested as a therapeutic agent for Diabetes Type 2. Aim : Τhe aim of this study is to measure FGF21 serum levels in diabetes mellitus patients, compare them with FGF21 levels in healthy individuals and correlate them with age, carbohydrate and lipid metabolism markers. Methodology : In this study. FGF21 levels in 35 diabetics and 23 non-diabetics were correlated with Glucose, HBA1c, Cholesterol, Triglycerides, HDL-cholesterol, LDL-cholesterol concentrations. Results : FGF21 concentration is doubled in diabetics. (both men and women). independently from the patients’ age. and it was statistically significant. No statistical correlation between FGF21 and other biochemical markers in diabetic and non-diabetic individuals. as well as within the two subgroups of participants aged <40 years old. and > 40 years old was recorded. Conclusion : FGF21 is an important metabolic regulator, which its concentration was found increased in diabetics serum, in the present study, while no statistical correlation was found between FGF21, age of the participants and other biochemical markers.

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DOI: 10.61873/EWMR7937

Authors: Dimitra Katsarou, Georgios Kougioumtzis, Efthymia Efthymiou, Maria Sofologi, Evangelos Mantsos

Abstract: Mental health interventions in schools are essential for supporting adolescents with neurodevelopmental disorders (NDDs). Schools offer a unique setting for early intervention due to their accessibility and continuity, promoting regular monitoring and engagement. This review explores a multi-tiered mental health framework that includes universal, targeted, and intensive strategies such as social-emotional learning (SEL), cognitive-behavioral therapy (CBT), peer-support programs, and culturally responsive practices. Evidence suggests that these interventions improve mental health outcomes, enhancing academic performance, social skills, and resilience. SEL programs build competencies like emotional regulation, while CBT reduces symptoms of anxiety, depression, and behavioral issues. Peer-support initiatives offer accessible support, reducing stigma within the school community. For students with NDDs, specialized interventions such as social skills training and applied behavior analysis (ABA) demonstrate positive impacts on social functioning and school engagement. The review also examines implementation barriers, including limited resources and the lack of culturally adaptable approaches. Teacher training and community involvement emerge as vital for bridging gaps in mental health support. Advocacy for policy and funding is essential to sustain these programs, ensuring they meet the diverse needs of all students. Through an inclusive, collaborative approach, school-based interventions significantly contribute to adolescent development and well-being.

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DOI: 10.61873/LVIF9748

Authors: Nagham Radhi, Ahmed Jasim, Samah Mohamed-Ali, Mafaz Mohsin

Abstract: Background: Periodontal diseases are common in patients with blood maladies, including chronic myeloid leukemia (CML). Yet, its effect on the periodontium is not well comprehended. Aim: This study assessed periodontal health in Iraqi CML patients using two key indices, gingival index (GI) and loss of attachment (LOA), and examined their cor­relation with white blood cell (WBC) counts. Methodology: A cross-sectional study was conducted with 100 partici­pants, including 50 CML patients and 50 age-and gender-matched healthy controls. GI and LOA were measured, and WBC counts were collected for the CML group to explore their association with periodontal health. Results: CML patients showed significantly worse GI and LOA scores compared to controls ( p < 0.05). A positive correlation was also found between WBC counts and the severity of periodontal disease in the CML group. Systemic inflammation and factors like tyrosine kinase inhibitor (TKI) therapy may contribute to this decline. Conclusion: CML patients are more likely to develop periodontal disease, emphasizing the necessity for integrated care that deal with both oral and systemic health. Comprehensive periodontal treatment and education, particularly in resource-limited settings like Iraq, are essential to improving the overall quality of life for these patients.

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DOI: 10.61873/YCAX7805

Authors: Stavroula Gakikou, Maria Noula, Evangelia Kotrotsiou, Zoe Roupa

Abstract: Background:Nursing is a major contributor to patient health outcomes, while job satisfaction in the field of healthcare is a factor that directly influences job performance and the quality of care provided to patients.Aim:The aim of this study was to investigate the level of professional satisfaction of the nursing staff in five public hospitals of the region of Thessaly (Greece) during the coronavirus disease 2019 (COVID-19) pandemic.Methodology:Data collection was done through an online questionnaire. The data collection was conducted over a period of four months, from May to September 2022, during the COVID-19 pandemic.Results:This is a synchronous, descriptive study with a sample of 750 members of the nursing staff. Women constituted 85.6% of the participants, while 42% and 26.5% of the employees were aged 41-50 and 51-65 years, respectively. The majority (66%) of the participants were nurses, 20.7% were nursing assistants, 16.3% held postgraduate qualifications, and 27.7% had served for 19-24 years. Participants experienced a moderate level of overall professional satisfaction. Of the participants, 79.5% had previously tested positive for COVID-19 and almost all (98.1%) had received the vaccine.Conclusion:During the COVID-19 pandemic, psychological, social, and physical stressors increased in an already stressful job, such as that of the nursing staff. Facing death, workload, fear, shortage of staff, and exposure to the risk of infection – all have affected job satisfaction. The existence of such dependencies should force the management to implement educational interventions in order to increase awareness in the nursing staff, with the ultimate aim of improving working conditions (that were considered inadequate) in a global public health crisis such as a pandemic.

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DOI: 10.61873/SEZR6390

Authors: Ahmad Al-Jalehawi, Samer Mohammed

Abstract: This comprehensive review examines the efficacy and safety of tumor necrosis factor-alpha (TNF-α) inhibitors in treating various autoimmune diseases, and focuses on their application in Iraqi patients. Elevated TNF-α levels are linked to autoimmune disorders, leading to the development of anti-TNF-α therapies such as infliximab, etanercept, adalimumab, certolizumab pegol, and golimumab, which have gained FDA approval for conditions like psoriasis, inflammatory bowel disease, ankylosing spondylitis, and rheumatoid arthritis. While these therapies demonstrate significant therapeutic benefits, including improved quality of life and disease management, they also carry risks, such as increased susceptibility to infections and potential malignancies. The review highlights the variable patient responses to TNF-α inhibitors, influenced by pharmacokinetic and pharmacodynamic factors as well as genetic variations. The rise of anti-drug antibodies and inadequate drug concentrations are common challenges observed, emphasizing the need for therapeutic drug monitoring. Safety profiles of TNF-α inhibitors are generally favorable, but adverse effects (including infections and infusion reactions) have been reported. Genetic factors, such as polymorphisms in the TNF-α gene, may also play a role in the treatment responsiveness and adverse effects, suggesting the potential for personalized medicine approaches. While TNF-α inhibitors effectively manage autoimmune diseases in Iraqi patients, further research is warranted in order to optimize treatment strategies, assess long-term safety, and explore genetic influences on therapy outcomes. The findings underscore the importance of individualized treatment plans so as to enhance the efficacy and minimize the risks associated with these biologic therapies.

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DOI: 10.61873/CFJQ3788

Authors: Naseer Mohammed, Haider Al-Saedi

Abstract: Background:Vancomycin (VAN) is widely employed in clinical settings for the treatment of severe infections attributable to multi-resistant bacteria, with a notable emphasis on Gram-positive strains. However, its therapeutic usage is significantly hampered by the potential for acute kidney injury (AKI); specifically, the nephrotoxic effects it can exert. In controlled experimental studies, the intraperitoneal (i.p.) administration of VAN at a dose of 400 mg/kg/day over a consecutive seven-day period has been shown to induce considerable AKI in rats. In addressing this concern, vitamin C (VC), recognized traditionally for its antioxidant properties, has been utilized to mitigate various forms of organ damage and inflammatory responses, primarily by diminishing oxidative stress and attenuating inflammation. Concurrently, tadalafil (TAD), a phosphodiesterase type-5 inhibitor commonly associated with the treatment of erectile dysfunction, is also noted for its beneficial anti-inflammatory and antioxidant effects, alongside vasodilatory properties.Aim:This study was designed in order to investigate the protective capabilities of TAD or VC against the VAN-induced nephrotoxic effects in a rat model of AKI.Methodology:A total of 24 male albino Wistar rats were allocated into four distinct groups for the purpose of comparative analysis. Following treatment, both kidney and blood samples were obtained for further evaluation. The study randomized the rats into four categories: group 1 served as the control group, group 2 received VAN at a dosage of 400 mg/kg (via an i.p. injection on a daily basis), group 3 was administered VAN (400 mg/kg; i.p., daily) in conjunction with TAD at a dose of 5 mg/kg daily, and group 4 was given VAN (400 mg/kg; i.p., daily) alongside VC at a dosage of 200 mg/kg daily.Results:Evaluations included the measurement of renal function indicators such as the serum levels of urea, of creatinine, and the creatinine clearance. Additionally, the analysis involved the assessment of antioxidant markers in renal tissue homogenates, including malondialdehyde (MDA), glutathione, and superoxide dismutase. To further elucidate the inflammatory response, indices such as the levels of the tumor necrosis factor-alpha, the interleukins (IL)-1β and IL-6, and the nuclear factor-κB were evaluated within the renal tissue homogenate samples of the studied rats. The administration of VAN resulted in a marked elevation of renal biomarkers and inflammatory indices, alongside a significant reduction in antioxidant levels, with an exception for MDA (which exhibited increased levels); these changes reached statistical significance (p

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DOI: 10.61873/ZEKU1257

Authors: Panagiotis Tsikouras, Stefanos Zervoudis, Nicole-Dimitra Sarantis, Antigoni-Dimitra Kyritsi, Christos Spanopoulos, George Iatrakis, Georgios Mastorakos

Abstract: Background: Currently the standard of care for premenopausal women with estrogen receptor-positive breast cancer is the combined use of a gonadotropin-releasing hormone (GnRH) analog with either tamoxifen or an aromatase inhibitor in patients at high risk for relapse or when it is deemed necessary to optimize ovarian function suppression. Monthly GnRH analogs have been used for years but, recently, longer-acting formulations have been gaining approval. Yet, there is still a gap of evidence regarding the use of longer-acting formulations; only a few studies exist that examine their efficacy in breast cancer and compare them to the monthly formulations. It is the investigators’ hypothesis that trimonthly injections, which are more convenient for the patient and ensure better compliance, are better suited for use in breast cancer patients and may induce equally effective estrogen suppression as the monthly injections. Aim: A comparison of trimonthly versus monthly GnRH analogs in eliciting ovarian function suppression in premenopausal patients with estrogen receptor-positive breast cancer. Methodology: This is a prospective randomized open-label trial involving 25 premenopausal patients that were randomized to receive either a monthly or a trimonthly GnRH analog. Estrogen (E2) levels, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) levels were measured on day 0 and on week 12. Patients, also, completed a questionnaire regarding exhibiting amenorrhea and other side-effects of the analogs. Results: All patients (N=25; 100%) from both groups achieved ovarian function suppression according to the criteria set by the researchers, which are E2 levels <30 pg/mL and amenorrhea. Both groups exhibited a statistically significant decrease (almost by 50%) in E2 levels by week 12 (monthly group: E2 levels’ decrease equal to -18.5 pg/mL, p =0.00293; trimonthly group: E2 levels’ decrease equal to -13.9 pg/mL, p =0.0002441). On the contrary, FSH and LH levels did not show a statistically significant difference in either group. Moreover, when the two groups were compared, there was no statistically significant difference in the variation of all hormone levels between day 0 and week 12. All patients developed amenorrhea. There were no statistically significant differences in the number of side-effects between the two groups, even though the trimonthly group had fewer (in absolute number) side-effects than the monthly. Conclusion: This study demonstrates that the trimonthly formulations of GnRH analogs are equally effective in eliciting ovarian function suppression and present a similar percentage of side-effects as the monthly formulations, with the added benefit that patients need not undergo monthly injections.

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DOI: 10.61873/FCLZ4180

Authors: Nawras Al-Kaabi, Qasim Jawad Amer Aljobory, Naer Abdulbari Madlool Alkaabawi

Abstract: Background: Cryptosporidium species are widespread protozoa and are considered an important cause of diarrhea in humans and animals. Aim: The aim of this study was to identify the occurrence of Cryptosporidium parvum in diarrheic sheep and goats from the rural areas of the Al-Muthanna Province, southern Iraq, based on molecular screening using PCR. The outcomes would help in determining the distribution of C. parvum in sheep and goats in the area, as well as the risk factors for the infection. Methodology: Sixty fecal samples were collected from clinically ill sheep and goats. The samples were submitted to PCR and sequencing that targeted the 18S rRNA gene in the protozoan. Results: The PCR revealed a 60% (18 samples) and 76.67% (23 samples) positive identification of C. parvum in sheep and goats, respectively. The sequencing demonstrated nucleotide similarities with isolates deriving from Iraq (MG878399.1) and India (JN836324.1) for the sheep isolates, and with isolates deriving from South Korea (DQ054819.1) and the USA (AF159112.1) for the goat isolates. Conclusion: C. parvum is the dominant species in the sheep and goats of Al-Muthanna Province, in southern Iraq. Moreover, the phylogenetic analysis demonstrates that the current study’s isolates may share the same ancestor with local and global isolates.

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DOI: 10.61873/PJZX5073

Authors: Noor Alsaigh, Waleed Arif Tawfeeq Al-Ani

Abstract: Background: The implementation of maternal dashboards in hospitals is both feasible and effective in improving healthcare quality. The dashboards provide rapid feedback on local outcomes in an accessible format and enable early detection of potential problems. They serve as a simple computerized tool that graphically presents the health facility’s clinical data, utilizing a traffic-light coding system so as to alert front-line staff about changes in the frequency of clinical outcomes. Aim: The aim of this study was to assess the effectiveness of the maternity dashboard in improving maternal health, reducing Neonatal Intensive Care Unit (NICU) admissions, as well as enhancing maternal and neonatal outcomes in an Iraqi hospital. Methodology: Data were collected over one year, from January 1st to December 30th, 2023. A prospective observational study (hospital-based record review) was conducted at the Obstetrics and Gynaecology Teaching Hospital in Kerbala, Iraq. Data were obtained from the medical records of all patients admitted to the obstetrical ward for labor, delivery, and the postpartum period during 2023. The maternal dashboard, a traffic light program (green, amber, red), was used in order to monitor outcomes. Data were collected manually from the outpatient department, the labor ward, the NICU registers, and the electronic records by using Excel. Results: A total of 136,519 women (who were either pregnant, in labor, or postpartum for up to 42 days) were admitted to the Obstetrics and Gynaecology Teaching Hospital in Kerbala during the study period, with 18,791 of them delivering. The implementation of the maternity dashboard resulted in significant changes: the normal vaginal delivery rate increased from 66% to 68% ( p =0.0024), the caesarean section rate decreased from 33% to 31% ( p =0.0001), the stillbirth monthly cases declined from 16±5 to 12±3 ( p <0.05), the NICU admission monthly instances decreased from 96±14 to 71±17 ( p <0.05), and early neonatal death monthly cases were reduced from 12±5 to 9±3 ( p <0.05). Conclusion: The study results show that maternity dashboards are vital instruments for monitoring and improving the quality of maternity care. They effectively enhance maternal and neonatal care quality indicators when comparing results before and after their implementation.

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DOI: 10.61873/EYQY2527

Authors: zahraa radhi, Fouad Gatea

Abstract: Background: Infertility is a prevalent problem that affects 15% of couples globally. Male infertility, which accounts for half of all cases, can be caused by several factors, including aging, drug use, genetic problems, and exposure to environmental toxins. Cyclophosphamide (CP) is a commonly utilized immunosuppressant and anticancer medication that can induce oxidative stress and harm the reproductive system of men. The beneficial effects of antioxidants in mitigating the CP-induced reproductive toxicities are well-documented. Aim: The aim of this study was to assess the effects of lecithin (as an antioxidant) against the CP-induced reproductive toxicity in male rats. Methodology: Thirty Sprague-Dawley male rats were divided into three groups: (i) the negative control group (that received sterile water via the intragastric route for 13 consecutive days), (ii) the positive control group (that received sterile water via the intragastric route for 5 days and, subsequently, a single, intraperitoneal dose of CP on day 6, followed by sterile water via the intragastric route for the next 7 consecutive days), and (iii) the lecithin-treated group (that received lecithin via the intragastric route for 5 days and, subsequently, a single, intraperitoneal dose of CP on day 6, followed by lecithin via the intragastric route for the next 7 consecutive days). Results: Lecithin treatment improved sperm parameters, plasmatic testosterone levels, and glutathione peroxidase, thereby preventing histopathological alterations in the rat testes. Conclusion: Lecithin demonstrated its potential protective effects against reproductive impairments and oxidative stress in the CP-treated rat group, and might prove promising for use in clinical practice as a protective agent against chemotherapy-induced male reproductive toxicity and infertility.

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DOI: 10.61873/DERC5205

Authors: Abdulsattar Mahmood, Sahar Al-Kazzaz, Maha Al-Saffar

Abstract: Background: An aphthous ulcer is a painful and recurrent oral mucosal inflammation that is retractable to treatments and resistant to healing. Conventional treatments include a variety of antiseptic, anti-inflammatory, and analgesic therapies, yet their efficacy remains inconsistent. Aim: The present study was conducted in order to evaluate the effects of ginger powder on the healing of chemically-induced aphthous ulcers in rabbits. Methodology: Twelve healthy rabbits were divided into control and ginger-treatment groups. Aphthous ulcers were induced in both groups. The treatment group received ginger powder topically in the socket every 24 h, for 7 days. Subsequently, all animals were sacrificed, and specimens were collected for macroscopic and histological examination. Results: Histological analysis of the ulcer sites on days 3 and 7 post-induction revealed that ginger-treated ulcers exhibited enhanced healing, as evidenced by increased collagen deposition, fibroblast proliferation, and re-epithelialization. Macroscopic observations also confirmed a faster regression of necrotic tissue and a reduced ulcer size in the ginger-treated group (as compared to the control group). Histological analysis has indicated significant differences in inflammation and blood vessel congestion between the two groups, particularly on day 7. Conclusion: The findings of this study reveal that locally applied ginger can enhance the healing in chemically-induced aphthous ulcers in rabbits, which may support its use in clinical practice.

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DOI: 10.61873/DSPQ4535

Authors: Momenah Yahya, Zeina Althanoon

Abstract: Background: Peptic ulcers are increasingly reported as a challenging disease in clinical settings. Several medications are employed in the management of peptic ulcers. Thus far, there is no medication devoid of any adverse effects that may achieve a 100% curative rate or provide a total remedy for the ailment. Aim: We aimed to examine the healing effects of trimetazidine against indomethacin-induced gastric ulcers in albino rats. Methodology: A total of 25 rats were used, divided into five groups (each group contained five rats): a negative control group that was only treated with distilled water, a positive control group that was only treated with a single dose of indomethacin (30 mg/kg) orally, a group that received indomethacin (30 mg/kg) and low doses of trimetazidine (17.5 mg/kg) orally, a group that received indomethacin (30 mg/kg) and medium doses of trimetazidine (35 mg/kg) orally, and a group that received indomethacin (30 mg/kg) and high doses of trimetazidine (52.5 mg/kg) orally. The induction of gastric ulcers occurred on the first day of the experiment through the administered indomethacin and, subsequently, the rats were treated orally with either trimetazidine or distilled water, three times daily, for 7 days. Serum urea, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and albumin levels were measured. Stomachs were excised from the rats’ bodies and opened along the greater curvature; they were then rinsed with saline, extended on a white corkboard, and examined macroscopically. The stomach tissues were also processed in order to generate microscopic slides for microscopical examination. Results: Indomethacin administration caused multiple ulcerations in the gastric mucosa, significant elevations in serum urea, creatinine, AST, and ALT levels, and a significant reduction of the serum albumin levels. The treatment with trimetazidine significantly healed the indomethacin-induced gastric ulcers. Conclusion: The present study indicates that the nonsteroidal anti-inflammatory drug (NSAID) indomethacin can induce substantial gastric ulcers, which may be linked to a direct toxic effect on the histological architecture of the gastric linings in addition to the reduction of blood flow to gastric mucosa; this effect can be treated by administration of trimetazidine. Ultimately, this study suggests that administering the optimal dosage of trimetazidine can be advantageous in treating stomach ulcers caused by NSAIDs. Moreover, the study suggests that the indomethacin-induced liver and renal dysfunction can also be alleviated by the use of trimetazidine.

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DOI: 10.61873/UCHB6154

Authors: Kyriaki Zervoglou, Vikentia Harizopoulou, Maria Bouroutzoglou, Thomai Kallia, Angeliki Antonakou

Abstract: Neonatal hypoglycemia is the most common metabolic disorder during the neonatal period. Despite its frequency of occurrence, there is no specific glucose concentration that defines it. Various symptoms and clinical manifestations characterize it, and its complications are related to its severity and duration. This review aims at comparing the recommendations of the American Academy of Pediatrics, the Pediatric Endocrine Society, and the Academy of Breastfeeding Medicine regarding the risk factors, the diagnosis, and the management of hypoglycemia. The complexity of hypoglycemia management and the research questions that need to be answered are highlighted by comparing the three guidelines. Preventing neonatal hypoglycemia by monitoring the maternal glucose concentrations, exploring and defining the optimal glycemic targets, investigating the long-term benefits after following these guidelines, and searching for less invasive diagnostic and therapeutic tools may help healthcare professionals make informed decisions to achieve better outcomes for these neonates.

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DOI: 10.61873/VSGM6033

Authors: Pinelopi Stamati, Anna Bilali, Kiriaki Gatanas, Aleksandros Ntourakis, Evanthia Ntouraki, Theano Tsakmaki, Dimitra Delga, Anastasia Sarigiannidou, Frosyna Anagnosti

Abstract: Background: The crucial role of innovation in healthcare management today as a driving force for long-term progress is more important than ever. Effective healthcare management is pivotal in achieving optimal health outcomes and operational excellence. Innovation in healthcare management refers to the implementation of contemporary or significantly improved methods, practices, or technologies that lead to better health outcomes, greater efficiency, and ameliorated patient experiences. Aim: The aim of this systematic review was to identify and analyze innovative practices in healthcare management that contribute to long-term progress. Methodology: An electronic search was conducted and databases included PubMed, Scopus, and the Cochrane Library, so as to examine the relevant material between January 2024 and May 2024. Inclusion and exclusion criteria were implemented. “Healthcare, management, innovation, AI, progress, long-term” was the combination of indexing words that was used. Results: Based on the undertaken search, a total of ten studies met the eligibility criteria as for the specific systematic review. Regarding the analysis of these ten studies, two were cross-sectional studies, two were qualitative studies, one was a qualitative interview study, one was a qualitative research through face-to-face survey, one was a quantitative study, one was a descriptive survey design, one was a study based on longitudinal data, and one was a study employing a multimethod qualitative approach. Conclusion: The role of innovation in healthcare management for long-term progress is pretty valuable. By offering solid leadership, a supportive culture, and a patient-centered approach, managers can promote innovation in healthcare organizations effectively and sustainably. Hence, there could be better patient outcomes and more motivated and engaged employees as a result of the effective implementation of innovation in healthcare management.

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DOI: 10.61873/OSLM1686

Authors: Safa Jihad, Rafal Al-Saigh, Hussam Al-Humadi

Abstract: Background: A mixed staphylococcal infection is a frequent opportunistic infection in immunocompromised patients and is often fatal, particularly in those with severe burns or other critical conditions. While S. aureus is typically the main culprit, S. epidermidis can also contribute significantly. Minocycline, a semisynthetic tetracycline antibiotic, can be effective on its own against multi-resistant staphylococcal infections. However, its exact effectiveness against different staphylococcal species is not fully known. Aim: We, herein, studied the efficacy of minocycline against two staphylococcal species ( S. aureus ATCC-25923 and S. epidermidis ATCC-12228 ), either alone or together, by using a new in vitro pharmacokinetics / pharmacodynamics (PK/PD) system. Methodology: This PK/PD system simulates minocycline human plasma levels with a C max of 2 and 4 mg/L, and allowed us to monitor bacterial growth spectrophotometrically based on the relative optical density (ROD) at 600 nm. Results: These two staphylococcal isolates ( S. aureus ATCC-25923 and S. epidermidis ATCC-12228 ) had minimum inhibitory concentrations (MICs) of 0.125 and 0.5 mg/L, respectively, which were tested in duplicate in an in vitro PK system with a fAUC 0-24 and a half-life of 12 h. The area under the bacterial growth curve (AUG ROD ) was used as the PD parameter. The in vitro PK/PD relationship was then used in order to assess the efficacy of minocycline through the fAUC 0-24 -AUG ROD relationship, which followed a sigmoid pattern (R 2 =0.874). Conclusion: The in vitro PK/PD modelling of minocycline’s activity showed that the standard dose of 4 mg/L can result in a drug exposure associated with maximal efficacy against each isolate, alone or together. However, a mixed staphylococcal infection with both isolates was associated with the best minocycline efficacy compared to S. aureus alone, although it was still non-significant.

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DOI: 10.61873/LZWY8467

Authors: Noor Abdalwahd, Hussam Al-Humadi, Rafal Al-Saigh

Abstract: Background: Systemic candidiasis can be seen in critically ill patients admitted to intensive care units, with high rates of morbidity and mortality. Candida albicans is the main causative agent of it. Aim: An in vitro pharmacokinetics (PK) / pharmacodynamics (PD) model has been developed in order to assess voriconazole against Candida albicans isolates. Methodology: This model examined the effect of standard dosing regimens of voriconazole (3.0 and 4.0 mg/kg with peak plasma concentrations of 1.5 and 3 mg/L, respectively) on two C. albicans isolates (the sensitive ATCC-90028 and the resistant ATCC-10231 ). A two-compartment model was used, with a 500-mL beaker filled with RPMI 1640 solution as the external compartment (EC) containing the drug. A peristaltic pump was connected to the beaker so as to circulate the solution into the EC and remove it at the same rate as the drug clearance. Additionally, a dialysis tube was placed in the EC in order to act as an internal compartment (IC), allowing molecules smaller than 20 kD to diffuse freely. The dialysis tubes (IC) were inoculated with C. albicans isolates and incubated, with samples regularly taken for PK and PD studies. PK studies involved sampling from both compartments for drug concentration analysis by using a bioassay, while PD studies monitored fungal growth by assessing the relative optical density. Results: The two simulated doses of 3.0 and 4.0 mg/kg of voriconazole effectively inhibited the growth of the two C. albicans isolates in a dose-dependent manner. The exposure-effect analysis showed over 99% efficacy with 4.0 mg/kg of the drug. Conclusion: Overall, the in vitro PK/PD system accurately demonstrated a significant growth inhibition with both standard doses (3.0 and 4.0 mg/kg) of voriconazole, in a dose-dependent manner.

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DOI: 10.61873/KBFF5140

Authors: Yasir Al-Mawlah, Duaa Hassan, Israa Alcharrakh, Reda Elfeshawy

Abstract: Background: Nanoparticles have attracted significant attention from researchers due to their intriguing properties, such as size and shape-dependent optical, antimicrobial, and electrical characteristics. Several different preparation techniques have been used to synthesize nanoparticles, including laser ablation, gamma irradiation, electron irradiation, chemical reduction, photochemical methods, microwave processing, and biological synthetic methods. Objective: As part of our research, we conducted experiments involving the extraction of silver nanoparticles from eggshell powder and explored their potential biological applications. Methodology: The synthesis of silver nanoparticles (AgNPs) from eggshell was analyzed using UV-visible spectroscopy, scanning electron microscopy, X-ray diffraction, and Fourier transform infrared spectroscopy. The antibacterial activity and anticancer potential of the AgNPs were determined using MTT assay against MCF-7 breast cancer cell lines. Results: The UV-visible analysis detected a peak at 480 nm, indicating the crystalline structure of the nanoparticles that were synthesized biologically. These nanoparticles have an average size of approximately 41.68 nm and exhibit a spherical shape. The synthesized silver nanoparticles exhibited strong antibacterial activity against multidrug-resistant clinical bacterial isolates, including Gram-positive bacteria such as Staphylococcus hominis and Streptococcus mutans , and Gram-negative bacteria such as Klebsiella pneumoniae and Escherichia coli , which are commonly associated with nosocomial infections. Through the utilization of the disc diffusion approach. The activity seen can be ascribed to the distinctive biological and physicochemical characteristics of the AgNPs, which aid in the rupture of bacterial cell membranes. The MCF-7 cell line exhibited the highest decrease when exposed to a concentration of 400 µg/mL of AgNPs. The results underline the potential of eggshell extract as an environmentally friendly and effective biological agent for synthesizing AgNPs with strong antibacterial and anticancer activities. Conclusion: AgNPs can be synthesized utilizing eggshell in an environmentally benign manner, and these AgNPs can serve as a cost-effective antibacterial and anticancer agent.

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DOI: 10.61873/HXXY9643

Authors: Abdulnaser Ali, Musab Khalaf, Abdulla Ahmad

Abstract: Background: 5-Fluorouracil (5-FU) is one of the commonly used anti-cancer drugs. However, it ranks as the second most common drug that causes cardiotoxicity. Ganoderma lucidum (G.L.) is a mushroom used for centuries for its different therapeutic properties. The aim of the study is to investigate the potential cardioprotective effect of G.L. against 5-FU cardiotoxicity, anti-inflammatory, and antioxidant properties. Material and methods: Thirty male Albino rats were divided into five groups. The control group was given normal saline orally for 14 days. The second group was treated as the control for 13 days and then 100 mg/kg 5-FU was administered intraperitoneally on day 14. The third group received G.L. 100 mg/kg orally for 13 days followed by a single 100 mg/kg 5-FU intraperitoneally on day 14. The fourth group was treated with 2 mg/kg enalapril orally for 13 days followed by a single 100 mg/kg 5-FU intraperitoneally on day 14. The last group received G.L. 100 mg/kg orally for 14 days. On day 15 the animals were euthanized, and blood was collected for biochemical analysis of cardiac biomarkers (troponin (TNNI3) and heart-type fatty acid binding protein (H-FABP)), oxidative stress markers (total antioxidant capacity (TAC) and malondialdehyde (MDA)), and the pro-inflammatory marker (tumor necrosis factor-alpha (TNF-alpha)). The heart tissue was isolated for the histopathological investigation of cyclooxygenase-2 (COX-2) expression. Results: 5-FU administration has led to an increase in the level of H-FABP, TNNI3, MDA, TNF-alpha, and COX-2 expression while it has significantly reduced the level of TAC. G.L. could prevent the 5-FU-induced cardiotoxicity via its effect on all the measured parameters. Conclusion: G.L. can potentially offers cardioprotection against 5-FU-induced cardiotoxicity through its antioxidant and anti-inflammatory effects.

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DOI: 10.61873/IBTM5678

Authors: Zeina Althanoon, Loay Alchalaby, Farah Ramzi, Marwan Merkhan

Abstract: Trihexyphenidyl is an antimuscarinic agent used for managing motor symptoms in Parkinson’s disease (PD). Despite its therapeutic use, trihexyphenidyl misuse and addiction have been reported. Its antimuscarinic effect alone does not explain this abuse potential. This study investigated if trihexyphenidyl produces psychostimulant-like behavioural effects in mice related to dopamine signalling. Male and female mice received 1 or 2 mg/kg trihexyphenidyl orally before open field and forced swim tests. Trihexyphenidyl at 2 mg/kg increased locomotor activity, prevented by olanzapine pre-treatment. It also decreased forced swim test immobility time. These findings suggest trihexyphenidyl has dopamine-mediated psycho-stimulant properties, providing preclinical evidence for its abuse liability. Further studies on trihexyphenidyl’s impact on dopamine neurotransmission and addiction risk are warranted.

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DOI: 10.61873/TOZB6842

Authors: Halima Qasim, Israa Jabber, Sami Ahmed, Marwan Merkhan

Abstract: Background: Attention deficit hyperactivity disorder (ADHD) is one of children’s neurodevelopmental psychological disorders with ideal therapy obscure. Aripiprazole is an antipsychotic medication with a unique mechanism of action that enhances dopamine activity in the prefrontal cortex in turn it might executive function in ADHD patients. This study aimed to clarify the impact of aripiprazole on ADHD using a socially isolated (SI) mice model. Methods: In the current study we used early-life SI mice as models for ADHD and tested three different doses of aripiprazole on attention set-shifting performance. The socially Isolated mice are known to have impairment in attentional set-shifting. Socially housed and isolated reared mice across different doses of aripiprazole for each stage were cross-matched for comparison. Results: Socially isolated mice showed selective great deficits in interdimensional discriminations and extradimensional discriminations. Aripiprazole at 3 and 6 mg/kg did greatly mitigate the cognition deficits in comparison with placebo and 1 mg/kg of aripiprazole. Conclusion: The current study results emphasise the positive effect of aripiprazole on cognition. Aripiprazole has the potential to be a treatment for ADHD with a psychostimulatory effect.

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DOI: 10.61873/AGND5435

Authors: Noora Abdulaziz, Eman Mohammed, Raghad Khalil, Yasser F. Mustafa

Abstract: For many years, natural bioactives have been used to treat, cure, and prevent diseases. Crude extracts from fruit seeds have been demonstrated to possess a range of advantageous biological properties, including anti-inflammatory, antioxidant, and anti-tumorous effects. In this study, the seeds of Garden Cress ( Lepidium sativum , Cr) were extracted using ethanol as a solvent and two extraction techniques. These methods are microwave-facilitated extraction and successive microwave-ultrasound-assisted extraction, resulting in Cr-1 and Cr-2, respectively. These two ethanolic extracts were investigated for several biochemical characteristics, including flavonoid content, phenolic content, antioxidant, anti-inflammatory, cytotoxic, and cytoprotective effects. The first and second characteristics were computed using the colorimetric AlCl 3 and Folin-Ciocalteu colorimetric methods, respectively. The antioxidant characteristic was investigated against two reactive species, named hydroxyl and DPPH. Also, the total reducing power was calculated in this regard. The anti-inflammatory-reducing characteristics of the extracts were evaluated employing three inflammation-progressing enzymes. The last two characteristics were assessed using MTT-based methodology in two malignant and one healthy cellular population, respectively. The outcomes demonstrated that the extract of microwave-facilitation (Cr-1) has the highest flavonoid and phenolic contents, as well as the best antioxidant activity. Furthermore, when compared to the other one, Cr-1 showed a greater inhibitory effect on inflammation-progressing enzymes and selectivity against COX2. At the applied concentrations, neither extract, however, had any antiproliferative effect on malignant or healthy cellular lines. Moreover, the extracts had no additional influence on the ability of 5-fluorouracil (5-FU) to stop the proliferation of malignant cells. However, when the extracts were individually applied with 5-FU, the cytotoxic capability of the drug in healthy cellular populations was substantially lowered. Given these findings, the authors concluded that using Cr-1 together with 5-FU may serve as a measure of normal cellular protection.

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DOI: 10.61873/ZFOR1179

Authors: Iryna Borisyuk, Mariia Shevchenko, Anna Tiutiunnyk, Polina Kovalenco, Nataliia Surtaieva

Abstract: Background: Analysing the modern pharmaceutical market is crucial for making management decisions, forming strategies, and ensuring competitiveness in this sector. Aim: Determination of the impact of various economic factors of the pharmaceutical industry on market conditions and development of economically justified areas of cost formation in the pharmaceutical market. Materials and Methods: A systematic review of scientific publications in the search databases Scopus, Web of Science, Medline, and Google Scholar was conducted. Statistical research methods used are observation, index and regression analysis. The methods of benchmarking analysis and interpretation were applied. Results: A detailed examination of published works by scientists and doctors has highlighted critical problems in forming the cost of medicinal products in the pharmaceutical market. The use of medicines worldwide and in individual countries has been considered, and a trend of increasing revenue in the global pharmaceutical market has been identified. The main approaches to forming pricing models in the pharmaceutical industry have been summarised. The peculiarities of the formation of EU legislation on the registration, production, sale, and quality control of medicinal products have been highlighted. The characteristics of the functioning of reimbursement programmes in certain countries worldwide have been described. A benchmarking analysis of the pharmaceutical market economy in Ukraine and the European Union has been conducted. Conclusions: The main directions for improving pricing policy in the modern pharmaceutical market have been outlined. It has been established that the main directions for forming the cost of medicinal products are expenses on research and development, costs of goods sold and patent expenses, marketing and advertising, regulatory and permitting procedures, and market competition.

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DOI: 10.61873/DAQO3640

Authors: zahraa naji, Noor Naser

Abstract: Molecular docking simulations were utilized to determine the binding affinities of five compounds produced. These compounds were IVa, IVb, IVc, IVd, and IVe. Chemicals derived from thiazolidin-4-one were designed to target cancer and human carbonic anhydrase IX (PDB code: 4M2V). These chemicals were designed to target humans. Our detailed sketching of the structure of the molecules was accomplished with the help of Chem Draw Ultra 12.0. To validate the compounds produced, the S. score and Rmsd values of the compounds were examined using the Molecular Operating Environment program. In contrast to acetazolamide, the proteins of the synthesized compounds had considerable binding affinities with the receptor active pocket, which suggested potential activity against cancer.

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DOI: 10.61873/CHCD3910

Authors: Tamara Tamm, Ivan Mamontov, Valentin Nepomnyashchy, Olha Danylova, Kostiantyn Sokol

Abstract: Taking into account that the prevalence of diabetes mellitus continues to increase worldwide, secondary complications associated with this endocrine disorder are becoming increasingly common. Disruption of glucose homeostasis and hyperglycemia lead to the activation of several pathological metabolic pathways, contributing to the development of vascular insufficiency and neurodegenerative processes in the lower limbs. These processes are the causes of a condition known as diabetic foot syndrome (DFS), which requires special attention and meticulous treatment. Complications in the form of trophic ulcers of the lower limbs are one of the serious consequences of diabetes mellitus (DM) since they often lead to severe medical and social problems, including high rates of limb amputations. The purpose of the research is to investigate the redistribution of plantar pressure depending on the volume of surgical intervention in patients with diabetic foot syndrome (DFS) by measuring individual statographic parameters. The analysis of a series of parameters from statographic studies in patients with diabetic foot syndrome undergoing various volumes of surgical interventions has allowed for a comprehensive understanding of the features of vertical standing of these patients. In the course of the research, it has been revealed that as the support area of the operated foot decreases, there is an increase in body oscillation in both the sagittal and frontal planes relative to the support area. It has been proven that in cases with a normal support area of the foot, the relative body oscillation decreases.

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DOI: 10.61873/JMSS4810

Authors: Stavroula Gakikou, Zoe Roupa, Maria Noula, Evangelia Kotrotsiou

Abstract: Introduction: The COVID-19 pandemic has exacerbated adversities associated with the working conditions of healthcare professionals, contributing to the deterioration of their physical and mental health, particularly as a result of work overload and daily stressors such as long working hours, low pay, lack of professional recognition, and high risk of infection. Purpose: The investigation of the effect of the COVID-19 pandemic, on occupational satisfaction, on work-related stress and in the quality of care of the nursing staff. Material and Method: Articles were searched in the electronic databases Medline, PubMed central, and Google Scholar. In Medline databases, PubMed central, Google Scholar, the combination of indexing words was used: “occupational satisfaction, nurses, quality of patient care, Covid -19 pandemic”, while in the PubMed database the advanced search option was used and the key words: “work-related stress, nurses, quality of care, Covid-19 pandemic”. Results: From the literature search, ten (10) studies met the inclusion criteria of the review. Upon analysis of these ten (10) studies, six (6) found an impact on occupational satisfaction affecting the quality of care, and four (4) studies identified a relationship between work-related stress and quality of care during the COVID-19 pandemic. Discussion – Conclusions: The collection of data and their analysis demonstrated that the healthcare system was severely tested during the COVID-19 pandemic. Factors influencing the occupational satisfaction and work-related stress of nurses, as well as patient care quality, include the increase in patient numbers, workload and working conditions, prolonged work hours, and shortages of staff and resources. Healthcare professionals endeavoured to cope with challenging work conditions, aiming ultimately to provide the best possible care to patients.

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DOI: 10.61873/LITC7985

Authors: Shahad Mohamedali, Shahad Khaleel, Doaa Ibrahim, Sadeel Shanshal

Abstract: Dyslipidemia is considered as the most common risk factor for cardiovascular diseases, cerebrovascular diseases, and fatty liver disease. The available therapy aimed to decrease lipid profile and reduced long-term risk which do require lifelong therapy, hence adverse effects are suggestive. The goal of the present study is to compare the antihyperlipidemic influence and hepatic side effects of CoQ10 and gemfibrozil in the hyperlipidemic male rats model. Twenty-five albino rats were divided into 5 groups: group 1 (normal group), group 2 (olive oil group), group 3 (hyperlipidemia-induced group) group 4 (CoQ10-treated group), and group 5 (gemfibrozil-treated group). Induction of hyperlipidemia lasts for 90 days and treatment lasts for 30 days. Serum liver enzyme analysis and liver histological study conducted to demonstrate the safety profile of the treatment agents. Analysis of the data revealed that the lipid profile parameters (except HDL) and liver enzymes were significantly (p

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DOI: 10.61873/RAKS3606

Authors: Alexandros Argyriadis, Chrisi Vlachou, Athina Patelarou, Evridiki Patelarou, Stiliani Kotrotsiou, Agathi Argyriadi

Abstract: Introduction: In response to the growing recognition of the importance of the quality care in psychiatric nursing, this study introduces the Psychiatric Nursing Care Quality Questionnaire (PNCQQ) designed to evaluate the quality of care provided to psychiatric patients from diverse cultural backgrounds. Aim: The aim of this research was to develop and validate a comprehensive tool that addresses the unique needs and perceptions of patients across various cultural contexts. Materials and Methods: The development of the PNCQQ involved a rigorous methodology encompassing item generation, expert review, and pilot testing to ensure its relevance and cultural appropriateness. Subsequently, a validation study was conducted with a diverse sample of psychiatric patients to assess the reliability, validity, and cultural sensitivity of the questionnaire. Results: A total of 932 psychiatric patients completed the Psychiatric Nursing Care Quality Questionnaire (PNCQQ) as part of the study. The sample consisted of 57.3% female and 42.7% male participants. The age of participants ranged from 18 to 75 years, with a mean age of 37.8 years. Results indicate robust psychometric properties, including high internal consistency and test-retest reliability, supporting the utility of the PNCQQ in assessing nursing care quality across diverse cultural populations. Conclusions: The implications of this research underscore the importance of culturally competent care in psychiatric nursing practice and highlight the value of utilizing validated instruments to enhance care delivery.

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DOI: 10.61873/XEVC6813

Authors: Taqwa Thanoon, Zeina Althanoon

Abstract: Maternal depression during pregnancy adversely affects offspring neurodevelopment and behaviour. Typical antidepressants like selective serotonin reuptake inhibitors have limitations due to risks of crossing the placenta. Ketamine has emerged as a promising alternative treatment. This research examined ketamine’s effects on offspring of maternally stressed mice. Dams were divided into control, maternal adversity, fluoxetine, and ketamine groups. Open field, sucrose preference, elevated plus maze, and forced swim tests assessed offspring anxiety, anhedonia, and despair. Maternal adversity increased anxiety-like behaviours and ketamine or fluoxetine reversed some effects. However, fluoxetine more effectively mitigated despair in forced swim tests. Ketamine moderately alleviated anhedonia versus controls. Further research on dose-response and timing is needed to optimize ketamine treatment. Mitigating maternal depression is crucial for preventing maladaptive offspring neurobehavioral trajectories.

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DOI: 10.61873/XSMT1055

Authors: Pinelopi Stamati, Frosyna Anagnosti, Anna Bilali, Kiriaki Gatanas, Argyro Anagnostaki, Aleksandros Dourakis, Evanthia Douraki, Eleni Riza, Emmanouil Pikoulis

Abstract: Introduction: The role of health systems and hospital administrative system in Covid-19 pandemic period is of utmost importance. Objective: The scope of study is to assess the preparedness, response competencies of administrative staff and resilience of health system as well as to highlight the need of modernizing the role of the above three components. Methods: 175 executives from public hospitals of the seven Regional Health Authorities in Greece participated in an online survey. Demographic, occupational data were collected and presented with correlations of individual variables. Results: The mental working condition of staff became much worse. The 96,7% of participants believed that the country does not implement a pandemic preparedness plan while 83,3% think that this plan has not been updated. Also, 38.9% of participants had no idea whether the strengthening of health system resilience is a current preoccupation of health policy makers. Conclusions: Measures of new managements are considered necessary for a successful reform effort. The organization of health systems and development of medical countermeasures are suggested as essential for the preparedness and response of Healthcare Administrative Staff of the Public Hospitals as well as the resilience of Greek Health System.

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DOI: 10.61873/CLHK4273

Authors: Alexandros Argyriadis, Efrosini Kleanthous, Chrisi Vlachou, Athina Patelarou, Evridiki Patelarou, Agathi Argyriadi

Abstract: Introduction: Research on depression and emotional distress related to diabetes is limited, despite significant research activity in this area being evident from recent literature. However, it is crucial, as indicated by recent findings, to examine this correlation, which may be linked to the improvement of the quality of life of patients with diabetes. Aim: The aim of this study was the analysis of depression and emotional distress related to diabetes. More specifically, it sought to delve deeply into the psychological aspects accompanying the management and experience of diabetes, shedding light on the potential emotional burdens and distress that individuals with this condition may face. Materials and Methods: This review utilized existing literature and scholarly databases such as Google Scholar and PubMed, as well as empirical studies concerning mental health. The study was conducted in Greece from September 2023 to February 2024. Results: Despite their similarities, depression and emotional distress related to diabetes are distinct conditions for mental health and require different evaluation and management strategies. Diabetes-related distress encompasses emotional experiences that overlap with several recognized mental health conditions, such as depression. Conclusions: In contrast to depression, diabetes-related emotional distress is not a psychopathological condition. It is an expected response to the diagnosis and management of diabetes, while depression refers to how people feel about their lives in general.

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DOI: 10.61873/XVQY6568

Authors: Stefanos Zervoudis, George Iatrakis, Panagiotis Tsikouras, Panagiotis Peitsidis, Angeliki Sarella, Christos Ampatzis

Abstract: Gynecomastia is very common cause of a patient’s visit to a mastology office. Gynecomastia is experienced in up to 70% of mid-puberty males and in up to 65% of middle-aged men. The treatment starts with the identification of the cause, but in most cases the patient is treated with tamoxifen, aromatase inhibitors, liposuction or surgery. Τreatment of gynecomastia is not well standarized. In our prospective study, we examined the use of tamoxifen followed by letrozole and a clinically important reduction was achieved, when compared with those who were treated only with tamoxifen. Further research needs to be conducted in order to confirm this promising protocol.

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DOI: 10.61873/FGXZ4557

Authors: Noor Aysa, Safa Aziz, Rafal Al-Assaly

Abstract: Nanoinformatics is a next-generation method for designing and simulating nanodrug candidates. It involves combining bioinformatics and quantum tools to predict and evaluate drugs. This approach addresses scientific problems in cheminformatics, configuration optimization, drug development, and administration. The integration of bioinformatics and quantum tools is crucial for the understanding of these advancements.

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DOI: 10.61873/HYIS8690

Authors: Noor Aysa, Lena Al-Jibouri, Rafah Almuttairi

Abstract: Smart nanopolymers with the capability to release drugs on demand and in response to specific illness signals, represent a promising avenue in the field of drug delivery. Their synthesis and characterization process involves the careful design of nanopolymeric structures, incorporating stimuli-responsive elements. The responsiveness of these nanopolymers to specific illness signals is evaluated through in vitro studies that simulate physiological conditions. The potential of these nanopolymers is explored in the context of personalized medicine, where tailored drug delivery systems respond to individual patient needs. The characterization of these smart nanopolymers showcases their potential as a novel and effective approach for on-demand drug release in response to illness signals. The findings contribute to the advancement of precision medicine and the development of innovative drug delivery systems with enhanced therapeutic efficacy and reduced side-effects.

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DOI: 10.61873/BAOW5445

Authors: Zaman I. L. Al-Kaabi

Abstract: Regulatory B-cells (Breg cells) represent as an important modulator of the immune system and their role is unique in autoimmunity, infection, tolerance to transplants, allergy, and cancer. Several regulatory mechanisms exist by which Breg cells can control the function of other immune cells through two main pathways: the secretion of soluble molecules and the use of cell surface-expressed molecules. Anti-inflammatory cytokine interleukin-10 acts as the hallmark of Breg cell function; other cytokines with a similar role include the transforming growth factor-beta and interleukin-35. Breg B cells also release the cytotoxic granzyme B that mediates cell apoptosis. Cell surface-expressed proteins include FasL, CD80, CD86, CD73, CD1d, and PD-L1. The present article reviews the immunosuppressive pathways in order to understand how they emerge and are induced to evoke their regulatory activities, and how we can benefit from them in the field of immunotherapy.

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DOI: 10.61873/DTFA3974

Authors: Shouli Yuan, Ismael Obaidi, Tao Zhang, Maria Pigott, Shibo Jiang, Helen Sheridan, Junying Liu

Abstract: Panax notoginseng (PNGS) is a potent folk therapy for blood-related diseases. However, further research is required to fully elucidate the mechanisms of its pharmacological activities and to explore its therapeutic potential for treating thromboembolism (TE) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed at analysing the molecular mechanisms of PNGS and at clarifying their potential role in treating TE induced by COVID-19, by employing network pharmacology and molecular docking. To this end, a network pharmacological approach was combined with expression profiling by high-throughput sequencing of GSE156701 so as to elucidate the compound constituents of PNGS for treating TE caused by SARS-CoV-2 at a systemic level. Protein-protein interaction network, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes analyses were employed in order to decipher the associated drug-target interactions. The integration of these results suggested that five targets, including the angiotensin-converting enzyme (ACE), the coagulation factor III (F3), interleukin-1 beta (IL-1β), the mitogen-activated protein kinase 1 (MAPK1), and the plasminogen activator inhibitor-1 (SERPINE1), represent major genes involved in thromboembolism. The data suggest that PNGS exerts collective therapeutic effects against TE caused by SARS-CoV-2, and provides a theoretical basis for further laboratory study of the active drug-like ingredients and the potential mechanisms of PNGS in TE treatment.

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DOI: 10.61873/RQJC3524

Authors: Luma Witwit

Abstract: Primary hepatocellular carcinoma is a devastating type of liver cancer. Silver nanoparticles (AgNPs) have been assessed for a variety of purposes, including being tested as an anticancer agent. The aim of this study was to assess the cytotoxicity of AgNPs that were biosynthesized from leech saliva on HepG2 cells, through the undertaking of a simple MTT assay. HepG2 cells were obtained from the cell bank of the Pasteur Institute of Iran. In this study, AgNP-treated HepG2 cells were cultured at a density of 10 4 cells per well, and 100 μL of MTT at a concentration of 0.5 mg/mL were added to each well; the treated cells were then let to incubate for 4 h. Subsequently, a plate reader device operating at a wavelength of 570 nm was used in order to determine the concentration of the chemical dissolved in isopropanol. Representative images of the cells show remarkable changes in their morphology at AgNP concentrations of 25 and 50 μg/mL. At 48 h, the nanoparticle’s IC 50 value was 50 μg/mL. Our study shows that leech salivary extract-derived AgNPs are cytotoxic to HepG2 cells.

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DOI: 10.61873/JLRE4978

Authors: Ali Hussein Shakir Al-Jailawi, Hayder Al-Hindy, Hayder Hashim

Abstract: Globally, breast cancer is the primary cause of cancer-related death, and rising incidence rates are anticipated. Improving illness prevention and treatment strategies requires a better understanding of the interactions occurring between genetic variables, environmental exposures, and disease pathogenesis. This study investigated the impact of residence on the association between benzo[ a ]pyrene-DNA adduct levels and CYP1B1 gene polymorphisms in breast cancer patients. In brief, 58 female breast cancer patients in Babylon, Iraq were recruited as subjects of this cross-sectional study. We gathered clinical information (including residency, age, age at diagnosis, and haematological markers), and by using molecular and biochemical methods, the CYP1B1 polymorphisms and the benzo[ a ]pyrene-DNA adduct levels were assessed. Among the different types of breast cancer, there was no apparent association between the residence and CYP1B1 polymorphisms. However, the amounts of benzo[ a ]pyrene-DNA adduct varied according to where a patient lived, with urban residents showing higher concentrations than rural residents. Benzo[ a ]pyrene-DNA adduct levels were shown to be correlated with specific polymorphisms in the CYP1B1 gene. Our study highlights the intricate connections between environmental exposures, genetic variables, and place of residency in the aetiology of breast cancer. Variations in quantities of benzo[ a ]pyrene-DNA adducts imply possible functions for environmental carcinogens, although no substantial correlation was found between genetic polymorphisms and the place of residence.

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DOI: 10.61873/LVGT1509

Authors: Israa Salim, Zainab Fadhil, Falah Hussein

Abstract: Globally, a massive amount of expired or leftover medications accumulates each year because of pharmaceutical overprescription, combined with overproduction. This pharmaceutical waste poses environmental, economic, and social/ethical challenges. The objective of this study is to understand societal behavior regarding the disposal of medications in the Babylon Governorate and develop a prototype of a knowledge-based system that promotes proper disposal of pharmaceutical waste. A two-phase cross-sectional study was carried out. The first phase involved interviewing pharmacists, while the second phase targeted the general population. A visit to Aljiumhori Hospital was made in order to assess the pharmaceutical waste disposal methods. The study found that most pharmacists (70%) and people (59.2%) prefer throwing expired medicine in the trash can. Moreover, 64.4% of the people participating in our study believe that placing unused drugs in special containers in each region is the best disposal method. Additionally, 48.2% of households are unaware of the environmental and health consequences of this waste. Pharmaceutical waste disposal in the Babylon Governorate is poorly managed. The absence of processes separating medical waste from general waste and the use of sanitary landfills as the sole method of disposal can pose serious environmental and public health risks. One can only address this issue with proper waste management, staff training, and protocol adherence.

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DOI: 10.61873/CGWA5841

Authors: Walaa Sabbar, Raghad Mouhamad, Ibrahim Murad, Entisar Al-Abodi

Abstract: Achillea millefolium L., a traditional medicinal plant from the Asteraceae family, is known for its anti-inflammatory, anti-ulcer, and anti-cancer properties, attributed to its rich content of phytochemicals (such as flavonoids, alkaloids, terpenes, tannins, and phenolic acids). This study has focused on the chemical analysis of the oil extracted from the aerial parts of Achillea millefolium subsp. millefolium , cultivated and harvested in Kurdistan, Iraq. The oil was extracted by using a Clevenger apparatus for hydro-distillation and was analysed by using gas chromatography with a flame ionization detector and an HP-5 MS capillary column. The analysis revealed the presence of 1,8-cineole (eucalyptus oil), Artemisia ketone, camphor, linalyl acetate, and D-limonene, with Artemisia ketone having the highest concentration at 15.04% and D-limonene the lowest at 7.51%. The extract of Achillea millefolium has been shown to aid in the treatment of oral mucositis (a common side effect of anticancer chemotherapy), likely due to the flavonoids and tannins present in the plant.

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DOI: 10.61873/GETK6172

Authors: Ameer Obed, Thulfeqar Hamza, Amal Talib Al Sa’Ady

Abstract: COVID-19 has been a global challenge caused by a coronavirus that infects the respiratory system and poses a high risk to life. This study dealt with some immunological indicators associated with this disease. A total of 150 samples was collected from COVID-19 patients (120 samples) and non-infected individuals (30 samples; control group) who were admitted to the Marjan Medical City Hospital in Al-Hilla, Babylon, Iraq for the period from March 1 to August 30, 2022. Of these participants, 65% were men and 35% were women, with ages ranging from 16 to 75 years. The samples were collected under the supervision of specialized doctors, according to the approved by the Iraqi Ministry of Health protocols. The parameters examined in this study included the complete blood count, the red blood cell (RBC) count, the packed cell volume, the haemoglobin levels, the platelet count, the white blood cell (WBC) count, and the levels of immunological indicators such as interleukin-1 beta (IL-1β), interleukin-17 (IL-17), the tumour necrosis factor-alpha (TNF-α), the C-reactive protein (CRP), and the erythrocyte sedimentation rate (ESR). Our results indicate a clear increase in the WBC count, the IL-1β levels, IL-17 levels, the TNF-α levels, the CRP levels, the ESR, and the RBC count, as well as a clear decrease in the lymphocyte count, as a result of COVID-19.

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DOI: 10.61873/KZWS3688

Authors: Ismael Obaidi, Fatimah Alzubaidi, Aymen Bash, Qayssar Fadheel, Hussam Al-Humadi, Junying Liu

Abstract: Renal cell carcinoma (RCC) is the most common type of kidney cancer, accounting for 90% of all estimated cases. Advanced RCC often carries poor prognosis due to its high metastases rate, the lack of early-warning signs, as well as its complex clinical manifestations and its resistance to chemotherapy. Ethnopharmacologically, Fructus Rosae laevigata (JinYingZi) has been employed by Chinese medicine to treat various urinary tract and gastrointestinal disorders. This study aimed at performing a series of mechanistic analyses in order to unlock the anticancer potential of JinYingZi-derived bioactive components against RCC. Several network pharmacology tools were employed so as to analyse the drug-disease interactions. Our data revealed that more than 2,214 genes were dysregulated in RCC, whereas the JinYingZi-derived bioactive compounds modulated 347 genes. The intersecting between RCC and the bioactive compounds revealed 132 cross targets. Our results were further validated by conducting molecular docking, which revealed a stable association between oleanolic acid with each of the following targets: androgen receptor ( AR ), dipeptidyl peptidase ( DPP ), estradiol ( ESR1 ), nitric oxide synthase 2 ( NOS2 ), and cyclooxygenase-2 ( PTGS2 ). Our approach is being used successfully in order to evaluate a panel of novel medicinal plant-derived bioactive compounds, and may lead to the identification of safe and effective chemical scaffolds that could act as templates for drug discovery or yield potential drug candidates.

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DOI: 10.61873/IVJV6786

Authors: Eman Nayif, Hashim Abass, Muthanna Abdlkhader Salh Al-Mahdawi, Frial Abd

Abstract: Stevia is herbal native to South-America that is renowned for its natural sweet leaves containing stevia glycosides. Our study aimed at examining and comparing the immunomodulatory effects of the Stevia rebaudiana leaf extract and of commercially-available stevia products in rats. Our experiment involved the preparation of Stevia rebaudiana leaf extract and the use of market-available stevia obtained from the local-market. Stevia rebaudiana leaf extraction was meticulously performed, and 60 healthy adult male rats were randomly separated into three groups: untreated control, commercial stevia treatment (25 mg/kg), and Stevia rebaudiana leaf extract treatment (25 mg/kg). The rats were orally administered the treatments for 60 days, after which blood samples were collected for analysis. Our results revealed a significant rise in interleukin-1 beta (IL-1β) levels in rats treated with the Stevia rebaudiana leaf extract and the commercially-available stevia when compared to the control group. Additionally, immunoglobulin A (IgA) levels exhibited a notable increase in both stevia-treated groups, with the Stevia rebaudiana leaf extract-receiving group showing higher IgA levels than the commercially-available stevia-treated one. Our findings suggest that stevia may influence the immune response, particularly the regulation of the pro-inflammatory cytokine IL-1β and the IgA levels. This study contributes valuable insights into stevia’s effects on the immune system.

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DOI: 10.61873/TVTQ4413

Authors: Ghada Naji, Fatima Al-Gawhari

Abstract: Bilosomes are nanocarriers that contain bile salts in their vesicular bilayer, thereby enhancing their flexibility and durability in the gastrointestinal tract. Unlike conventional vesicular systems they provide distinct advantages such as streamlined manufacturing procedures, cost efficiency, and improved stability. The main objective of this study was to attain a comparison of the pharmacokinetic parameters of nisoldipine (NSD) after administering an ordinary NSD suspension and an NSD-loaded bilosome suspension. The study used 60 Swiss albino rats weighing 200±15 g and divided into two groups (n=30 each). A dose of 2.2 mg/kg of NSD was administered from the ordinary NSD suspension to the rats of the first group and the same dose of NSD-loaded bilosome suspension was administered to the rats of the second group. NSD levels were determined in the rat plasma by using high-performance liquid chromatography. Our results showed that the C max , the T max , and the AUC 0-36 were 51.47±0.94 ng/mL, 2±0.3 h, and 323.33±21 ng×h/mL for the pure suspension, and 116.41±1.22 ng/mL, 4±0.7 h, and 916±64.09 ng×h/mL for the bilosome suspension, respectively. The maximum concentration was significantly different between the pure and the bilosomal preparation ( P <0.05), while the relative bioavailability of the pure suspension was 2.9 times that of the bilosomal suspension, 36 h after a single-dose NSD administration. In conclusion, the prepared bilosomal suspension enhanced the bioavailability of NSD, and could be considered as a vital delivery system.

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DOI: 10.61873/HHPT2430

Authors: Mazin Mousa, Hayder Al-Hindy, Amir Al-Mumin

Abstract: Cystatin C (CysC) levels in patients with multiple myeloma (MM) have been linked to tumour load and outcomes’ prediction. This study aimed at assessing the diagnostic utility of CysC in distinguishing MM patients from controls and advanced stages of MM. In total, 98 MM patients and 57 healthy controls participated in this cross-sectional case-control study. Demographic, clinical, and biochemical data were assessed. The study groups exhibited significantly diverse measures of urea, creatinine, CysC, β 2 -microglobulin, and lactate dehydrogenase activity. β 2 -Microglobulin was found to be a reliable predictor for both the MM staging and its diagnosis, but CysC was found to only possess a partial capacity of predicting advanced MM stages. Our results highlight the significance of taking into account many biomarkers in the therapy of MM, so as to achieve effective clinical evaluation. More research is required in order to clarify the CysC implication in the prognosis and management of MM.

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DOI: 10.61873/KMKM8961

Authors: Marwan Mahtook, Maiss Saadi, Saifan Alhameedawi, Noor Obaid, Khulood Alsaraf

Abstract: Musculoskeletal pain includes several types of discomfort associated with the skeletal system. Pharmaceutically, pridinol was developed in order to relax muscles. No empirical data exist to support the effectiveness of using meloxicam in combination therapy for the treatment of musculoskeletal pain. This study compared pridinol and meloxicam for musculoskeletal pain. The current observational study assessed a total of 82 patients. The study’s participants were divided into three groups: the “meloxicam” group, the “pridinol” group, and the “meloxicam + pridinol” group. Pain levels were measured before and four weeks after giving the drug, by using a visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). We employed a Kruskal-Wallis test in order to evaluate the variations in pain measurement among the groups. The three groups’ VAS and WOMAC scores did not differ before the drug administration. The “meloxicam + pridinol” treatment resulted in significant pain relief based on VAS and WOMAC scores at 1, 2, and 4 weeks (as compared to other groups; p <0.05). At 4 weeks, the VAS and WOMAC ratings exhibited no significant pain relief in the “meloxicam” group when compared to the “pridinol” group. The meloxicam-pridinol combination proved efficacious for musculoskeletal pain, and is recommended for its therapy.

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DOI: 10.61873/FMPT5825

Authors: Ola Khdhair, Yazi Jassim, Noor Abed Alreda Alkremy, Taif Al-Ameedy

Abstract: Burns and wounds destroy the physical skin which is the body’s natural barrier to the external environment. As a result the burned area is prone to infection and colonization by microorganisms. The most common pathogenic colonizing bacterium is Staphylococcus aureus . In order to solve the problem of bacterial resistance to antibiotics, some medicinal plants have been used so as to determine their effectiveness against S. aureus . Among these plants, we have herein used the alcoholic extract of berberine. Our results suggest that the alcoholic extract of berberine, at a concentration 250 mg/mL, can exert a high inhibitory efficacy against S. aureus .

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DOI: 10.61873/ORXR1322

Authors: Esaim Fadhel Khalfa, Rawaa Abdullah, Qasim Al-Daami, Aymen Bash, Saba Abdulmunem Habeeb Al-Qaysi, Ghassan Mohammed, Widad Abd Al-Jabbar Mozzan

Abstract: A straightforward and sensitive method for high-performance liquid chromatography (HPLC) was created in order to separate and identify the di-stereoisomeric mixture of a spiro-oxalidinonic derivative of sorbinil. HPLC was carried out using a C18 reversed-phase column. The mobile phase used in the isocratic elution process was a 70:30 v/v combination of methanol and acetonitrile flowed at a rate of 2 mL/min. The procedure delivered the best result among the various attempts made. Two peaks were identified on the chromatogram, attributable to the two di-stereoisomers of the mixture analysed. Analogues of sorbinil, a powerful inhibitor of aldose reductase, have been synthesized and further tested on aldose reductase as mixtures of di-stereoisomers, exhibiting an IC 50 in the order of the micromolar. The structure of the compounds was checked with nuclear magnetic resonance spectroscopy. The chemical shifts were expressed in ppm scale δ.

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DOI: 10.61873/ILCP1133

Authors: Safa Jihad, Rafal Al-Saigh, Hussam Al-Humadi

Abstract: The emergence of anti-staphylococcal drug resistance has significantly increased, thereby making it difficult to control the life-threatening staphylococcal infections. A validated two-compartment in vitro pharmacokinetics / pharmacodynamics (PK/PD) model has been used in order to estimate the efficacies of some anti-staphylococcal drugs – namely, vancomycin (maximum concentration or C max of 3 and 5 mg/L), teicoplanin (C max of 5 and 10 mg/L), and minocycline (C max of 2 and 4 mg/L) – against a mixed staphylococcal infection ( S. aureus ATCC 25923 and S. epidermidis ATCC 12228), with or without human albumin (2%). The PK profile for each drug was simulated as time-concentration depending on the drug’s half-life. The minimum inhibitory concentration (MIC), the relative optical density for bacterial growth, and the exposure / effect relationship (fAUC 0-24 /MIC) have also been assessed in this study. Our results revealed that minocycline has the best efficacy over other antibiotics against the assessed isolates (single or mixed). Moreover, the addition of albumin exhibited a negative effect on vancomycin and a positive effect on teicoplanin in both the single and the mixed infections. In conclusion, albumin drew a different antibiotic scenario in response to different pathogens.

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DOI: 10.61873/GSPT1121

Authors: Sura I. A. Jabuk, Anmar M. K. Al-Maamori, Raflaa S. H. Hussian, Zahraa Al-Taee

Abstract: Proteus mirabilis is a genus of bacteria that can cause foodborne diseases. We collected 100 canned food samples from local supermarkets in Hillah (Iraq), including juice (23%), milk products (22%), beef (20%), fish (14%), milk (12%), and tomato paste (9%) samples. We subsequently characterized some virulence factors of P. mirabilis found in these foodstuff, including biofilm formation, protease activity, motility, haemolysis, adhesion, urease production, lipase production, and antibiotic susceptibility. In a total of 32 foodstuff samples of positive culture, P. mirabilis was isolated in 15 (46.8%), including 3 juice samples, 4 milk product samples, 2 beef samples, 1 fish sample, 3 milk samples, and 2 tomato paste samples. All isolates exhibited swarming motility (100%) and urease production (100%), while none of the isolates was found to produce haemolysin. The results of the antibiotic susceptibility test revealed a higher resistance against ampicillin (86.6%).

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DOI: 10.61873/SLSI4403

Authors: Falah Hussein, Halla Hassan

Abstract: The efficacy and easy access to antibiotics have led to their overuse, which allows for the development of resistance to them. This study took Babylon Governorate as a model to prove whether the above hypothesis is true or not. We aimed at exploring whether there are any restrictions for dealing with antibiotics by pharmacists in the Babylon Governorate, at identifying the distribution of pharmacies in Hillah, and at estimating the capability of the health authority to control them. A total of 165 pharmacies were visited in an attempt to purchase antibiotics without a prescription. Antibiotics were obtained from 164 pharmacies, and one pharmacy apologized because they did not have the antibiotic. Moreover, a survey was randomly distributed to different pharmacies and pharmacists asking them whether they sell antibiotics without prescriptions, and an online questionnaire was distributed to pharmacists and pharmacy students in the Babylon Governorate. The results revealed that the percentage of pharmacies that sell antibiotics without medical prescription is 98%; the remaining 2% belongs to the pharmacies that do not stock these antibiotics. We hypothesize that the main reason for this phenomenon is the chaotic distribution of pharmacies in the Governorate, and the lack of supervision by the authorities. Mapping has revealed a random distribution of pharmacies in Hillah, which is performed in an unscientific manner without taking into account whether these areas need pharmacies or not. Moreover, the lack of supervision by the Government and the health syndicates allows for antibiotics to be largely dispensed in the pharmacies without a medical prescription.

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DOI: 10.61873/UAUF7136

Authors: Nada Khazal Kadhim Hindi, Baraa Hadi, Lubna Abdul Muttalib Al-Shalah, Ahmed Abbas

Abstract: Cydonia oblonga is effective against many infections and has medicinal properties that are useful in the treatment of many other diseases. The aim of this study was to elucidate the antimicrobial activity (in the form of anti-adherence and anti-biofilm formation) of the aqueous Cydonia oblonga extract. The biological activity of the extract was compared to that of imipenem. All bacterial isolates of Gram-positive and Gram-negative bacteria assessed were found to be susceptible to the Cydonia oblonga extract and the zone of inhibition ranged from 24 to 34 mm. Most bacterial isolates were resistant to the antibiotic, and some bacterial isolates were sensitive to imipenem. The adherence and biofilm formation inhibitory activities in the presence of the aqueous extract of Cydonia oblonga were found to be moderate or elevated in most of the Gram-negative bacteria assessed. According to our findings, the aqueous Cydonia oblonga extract displays great effectiveness (and promise) against many pathogenic bacterial isolates.

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DOI: 10.61873/FWIT2515

Authors: Asmaa Hammadi, Saba Habeeb, Lena Al-Jibouri, Samir Malik, Fatema Samer Al Bdear, Amal Adnan

Abstract: In our study, zinc oxide (ZnO) nanoparticles (NPs) were prepared by precipitation (economically and in high quality) at a temperature range of 60°C to 80°C and at pH 8, and were then adorned with graphene (G) plates. To determine its antimicrobial potential, the ZnO/G complex was loaded with metronidazole. The morphology and diameter of the ZnO nanocomposite before and after the loading were validated by scanning electron microscopy. The average size of the ZnO NPs was found to be 20–40 nm, while X-ray diffraction examined how the physical features of these NPs varied from those of its individual components with an average size of 28.1 nm. The assessment of the ZnO/G complex’s antibacterial efficacy against Gram-positive and Gram-negative bacteria was the main aim of our work. The agar well diffusion technique was used in order to assess the antibacterial activity of the ZnO/G complex with and without metronidazole. Our study demonstrates that the ZnO/G complex possesses antibacterial activity and might increase the antibiotic action by inhibiting Gram-positive bacteria (more than Gram-negative ones). It is, therefore, concluded that the ZnO/G NPs could be of use in formulating nano-drug conjugates that could act as antimicrobial agents.

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DOI: 10.61873/AFGH8682

Authors: Raniah Chalawi, Mohammed Ezzat

Abstract: The lack of safe and effective antiepileptic drugs is a persistent issue that could be addressed through the repurposing or further development of commonly available drugs. Due to high accuracy, low effort, and high cost, it is best to begin the search for alternative treatments with a theoretical chemical study. Isoindoline derivatives, their ΔG, and their molecular docking were subjected to the molecular level theory. Having a ΔG of -4.9, compound A1 demonstrated a unique activity against protein 1OHV (4-aminobutyrate-aminotransferase; from pig), while the same compound demonstrated distinct activity against protein 3F8E (coumarins as suicide carbonic anhydrase inhibitors) with a ΔG of -4.533. Moreover, compound A3 exhibited a unique activity against protein 6KZP (calcium channel-ligand) with a ΔG of -7.597. The undertaken DFT analysis determined the highest occupied molecular orbital (HOMO), the least unoccupied molecular orbital (LUMO), and the HOMO-LUMO gap values for the studied derivatives (compound A1: -0.202, -0.091, and -0.111 eV; compound A3: -0.228, -0.102, and -0.126 eV, respectively). The ionization potential, the softness, the hardness, and other chemical properties of these compounds were subsequently computed. Drug likeness predictions were employed in order to show that the compounds adhered to Lipinski’s rule. Our results indicate that the molecular mass, log P, as well as the hydrogen bonding donors and acceptors of the herein assessed isoindoline compounds fall within acceptable ranges.

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DOI: 10.61873/SVRL5228

Authors: Fatima Alzubaidi, Enass Oubaid, Zahraa I. J. Shubber, Hussam Al-Humadi, Rafal Al-Saigh

Abstract: Reinfection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has been documented all over the world. Currently, limited evidence exists concerning the protection afforded by the COVID-19 vaccination against reinfection with SARS-CoV-2. This case-control study was performed in order to assess the association between COVID-19 vaccination and SARS-CoV-2 reinfection in the Babil Province; the study used an electronic questionnaire. The infected patients were 115 (aged ≥18 years) and were confirmed by a positive PCR and/or a CT scan, they were either fully vaccinated or not with a second dose of a (Pfizer, AstraZeneca, or Sinopharm) vaccine before the reinfection date, and they were compared with 300 control participants. The study’s findings revealed that the unvaccinated individuals had 4.5 times the odds of reinfection compared to those who were fully vaccinated, without preference for the manufacturer of the vaccine. The conclusion suggests that getting fully vaccinated against COVID-19 can significantly reduce the likelihood of reinfection, can enhance overall protection, and can minimize the risk of future infections.

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DOI: 10.61873/IJZC4054

Authors: Hawraa Al-Yassery, Enas khadim

Abstract: The presence of alkaloids in Crassula ovata is a topic that is still unexplored, as there are no published studies on the matter. This study demonstrates the presence of an alkaloid compound (and its class) for the first time in Crassula ovata . The plant material was defatted with n-hexane, and a Soxhlet apparatus was used for the extraction process, while the acid-base method was used for the isolation of alkaloids from the chloroform fractions. The quaternary alkaloid was precipitated from the aqueous layer spontaneously, in high quantity. By using standard spectroscopic methods (including liquid chromatography – mass spectroscopy) we were able to clarify the structure of the precipitated compound as a tetrahydroprotoberberine alkaloid based on the general fragmentation pattern of this class of alkaloids and the retro-Diels-Alder reaction; a characteristic fragmentation pathway of tetrahydroprotoberberine alkaloids.

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DOI: 10.61873/JMOB1139

Authors: Hawraa Al-Yassery, Enas khadim

Abstract: The current study shows the cytotoxicity effect of the Crassula ovata n-hexane extract on esophagus cancer. C. ovata is a perennial succulent plant belonging to the Crassulaceae family. In Africa, the leaves were used medicinally to cure epilepsy and diarrhoea by boiling them in milk. The hexane fraction, which is obtained through the maceration method, demonstrates the presence of many compounds that have an anticancer effect, which are obtained by gas chromatography – mass spectroscopy. The phytosterol compound was isolated by a preparative thin layer chromatograph and was identified by liquid chromatography – mass spectroscopy. The hexane fraction was found to possess a strong anticancer effect against esophagus cancer. The obtained data from the human esophagus cancer KYSE-30 cell-line were analysed by one-way ANOVA, with a significance level of p <0.05.

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DOI: 10.61873/TXET1445

Authors: Alaa Hamady Obeid Al-Taei, Rasha Saleh, Samah Kadhum, Aseel Omran, Ruqaya Munther Jalil Ewadh, Hasanain Owadh

Abstract: The antimicrobial activity of the aqueous and ethanolic extracts of Myrtus communis , Ammi visnaga , and Equisetum arvense was investigated against Staphylococcus aureus , Escherichia coli , and Candida albicans by using the agar well diffusion method. Serial concentrations (15%, 30%, and 50%) of the extracts of each plant were tested and compared with gentamicin (10 μg) and fluconazole (25 μg). Most of the extract concentrations showed a relatively high antimicrobial activity against all the tested microbes, and the ethanolic extract was more effective than the aqueous extract. The activity of plant extracts increased with the increasing extract concentration of Myrtus communis , which appeared to possess a more antimicrobial activity than the other plants assessed; in fact, its ethanolic extract exhibited the highest inhibition zone against S. aureus (32 mm). The ethanolic plant extracts at a concentration of 50% displayed the maximum activity against the herein assessed isolates. Moreover, E. coli showed a higher sensitivity to most extracts, while the lowest effect being noticed on C. albicans .

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DOI: 10.61873/IXYC6187

Authors: Lubna Abdul Muttalib Al-Shalah, Huda Mohammed, Alaa Omran, Azhar Althahab, Frial Abd

Abstract: When bacteria attach to the human body, they have many defense mechanisms. These mechanisms pose a global health risk. Medicinal plants can be used to control such bacterial attack mechanisms. The aim of this study was to assess the antimicrobial potential of an aqueous extract of Salvia rosmarinus and other plant extracts against some clinical bacterial isolates. The antimicrobial activity against Gram-positive and Gram-negative bacteria ( S. aureus , E. coli , P. aeruginosa , Proteus spp., and Klebsiella spp.) was determined by using the agar well diffusion method. When compared to an alcoholic extract, the aqueous extract of Salvia rosmarinus inhibited the studied bacterial isolates with greater efficiency.

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DOI: 10.61873/RYGM9424

Authors: Rafal Al-Saigh, Ali Al-Saigh, Ihab Ahmed, Sally Bash, Muataz Hussein, Mohamed Abdelrahman

Abstract: Acute decompensated heart failure (ADHF) is a leading cause of hospital admission and many factors are known to precipitate decompensation. We aimed to assess the decompensating factors of heart failure and the management of patients admitted to the emergency department (ED). A total of 107 patients were examined, all diagnosed with ADHF in the ED of the Baghdad Teaching Hospital, from June 2017 to December 2017, and presenting with decompensation (pulmonary oedema, peripheral oedema, and fatigue). The mean patient age was 62.5 ± 9.8 years (range: 43–85 years); the majority of them were in their 7th decade (37.4%), and men were slightly more than women. Hypertension was the most commonly associated comorbidity (68.2%), followed by diabetes mellitus (57.9%), coronary artery disease (51.4%), dyslipidaemia (37.4%), arrhythmia (28%), and chronic obstructive pulmonary disease / asthma (23.4%). The most common presentation was pulmonary oedema (88.8%) followed by peripheral oedema (61.7%), and fatigue (26.2%). Uncontrolled hypertension was the most common precipitating condition for decompensation (58.9%), followed by infection (39.3%), acute coronary syndrome (31.8%), arrhythmia (27.1%), non-compliance (11.2%), and anaemia (2.8%). The majority of the admitted patients were managed with intravenously-administered (i.v.) diuretics (92.5%) that may have been combined with oxygen therapy (63.6%), antibiotics (58.9%), β-blockers (50.5%), nitroglycerin (40.2%), i.v. fluids (38.3%), and/or digoxin (19.6%).

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DOI: 10.61873/HNKR5864

Authors: Nada Alkhafaji, Hussein Al-Harbi

Abstract: Alhagi maurorum is one of the many plants that have proven effectiveness in folklore medicine and that are still utilized to treat disease or disorders, thanks to their phytochemical compounds and other secondary metabolites. Sulfadimidine, chemical known as 4-amino- N -(4,6-dimethylpyrimidin-2-yl)benzene-sulfonamide, is an antibacterial drug that has side-effects on organs such as the kidney. In this study, the unwanted acute effect of this sulfonamide and of its metabolites was recorded in the form of rat interstitial nephritis and as an increase in creatinine and blood urea nitrogen (BUN) levels. Results showed a significant ( P <0.05) decrease in BUN levels in rat groups treated with the ethanolic extract of Alhagi maurorum as a therapy, but there were no significant differences observed in terms of the creatinine levels in these groups. The undertaken histological study revealed an almost normal histological appearance of the kidneys in the two groups of rats that were treated with the plant extract as a therapy after the damage that occurred as a result of the drug injection (interstitial nephritis, infiltration lymphocytes, and mild tubular atrophy). Our study suggests a potential benefit from natural plants in the treatment of drug-related adverse effects.

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DOI: 10.61873/DANB7861

Authors: Jenan Mahdi Jawad Al-Kawaz, Hussein Al-Harbi, Fakhir Al-Zubaidy

Abstract: Gastric ulcer is the most common health concern due to alcohol consumption, smoking, and physiological stress. An ethanol-induced gastric ulcer in an animal model resembles the pathophysiology of the human ulcer. The present study attempted to detect the protective effects of esomeprazole, curcumin, chitosan, and a mixture of curcumin and chitosan on ethanol-induced gastric ulcers in female rats. The present study included 60 rats with an average weight between 179.1 and 180.3 g, divided into two control groups and four treated groups (esomeprazole, curcumin, chitosan, and mixture), where each group included 10 rats. All groups were treated for 30 days. In order to induce a gastric ulcer, absolute ethanol (2 mL/rat) was given orally to all groups (except the negative control ones) after a period of fasting of 20 h. All animals were sacrificed 5 h later. The gastric ulceration was studied by comparing the volume and the pH of the gastric juice, the ulcer index as well as the protective index. Our results revealed a significant decrease ( P <0.05) in the values of the ulcer index and the volume of gastric juice in the esomeprazole-, curcumin-, chitosan-, and mixture-treated rats as compared to those of the positive control group. The value of the gastric juice pH exhibited a significant increase ( P <0.05) in these same groups.

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DOI: 10.61873/UUXZ2461

Authors: Hajir Aljaryan, Ataa Al-Shamari, Taif Al-Ameedy, Amal Talib Al Sa’Ady, Samir Malik

Abstract: Gastrointestinal cancers, including stomach, liver, oesophageal, pancreatic, and colorectal cancers, represent more than a quarter of all cancers. Many abnormal gene expressions and dysregulated signalling pathways have been found in human cancer. Cancer often has activating mutations of the KRAS (Kirsten rat sarcoma virus) oncogene. Fifty blood samples from gastrointestinal cancer patients were gathered from the Merjan Teaching Hospital in Babylon, Iraq, and were used for a case-control study in the Oncology Center. According to the results, the most common cancers were found in the colon (29%), followed by the liver (27%), pancreas (19%), stomach (13%), and other (12%). In this work, we evaluated the distribution of KRAS mutations across the gastrointestinal tract. Sequencing data revealed a significant regional difference in the frequency of KRAS mutations, while the alignment results revealed the presence of six variations in the analysed samples when compared with the referring reference DNA sequences. Six highly interesting nucleic acid polymorphisms were detected in the investigated samples. When combined with additional carcinogenic markers such as the patient sex, age, consistent molecular subtypes, and tumour stage, KRAS mutation is not the deterministic carcinogenic factor for gastrointestinal malignancies.

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DOI: 10.61873/XFAQ5379

Authors: Aamer Ali, Noor Hussein, Dhafer Jawad, Hayder Abed, Shereen Mekkey

Abstract: The popularity of stevia is high, especially among diabetics and those looking to reduce their calorie-intake. The aim of this study was to compare the effects of a commercially-available stevia and of a Stevia rebaudiana leaf extract on the liver function and histology of rats. After preparing the Stevia rebaudiana leaf extract, 60 healthy adult male rats were randomly separated into three groups: untreated control, commercial stevia treatment (25 mg/kg), and Stevia rebaudiana leaf extract treatment (25 mg/kg). Our results show that after 60 days of treatment (oral administration), a significant elevation of the alanine aminotransferase (ALT) levels was observed in the commercial stevia-treated group, suggesting potential effects on liver function. The Stevia rebaudiana leaf extract-treated group also exhibited increased ALT levels. Moreover, the aspartate aminotransferase (AST) levels were found significantly increased in both of these treatment groups (when compared to the control group). Alkaline phosphatase levels were not found altered between groups. Histological-examinations, in spite of the elevated ALT and AST levels, exhibited no abnormalities in the liver. Although stevia is generally regarded as safe, this study underlines the importance of considering the type and form of stevia when evaluating its effects on liver health. Further study is warranted so as to elucidate the specific components and mechanisms responsible for the observed variations in liver enzymes, and to confirm the overall safety of stevia products.

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DOI: 10.61873/FMGQ9899

Authors: Farah Al-Humadi, Hiba Qassim, Ali Hameed, Ali Jihad Hamid Al-Athari, Bushra Umran, Rafal Al-Saigh

Abstract: An intrauterine system (IUS) is a type of contraception tool that is used in order to control fertility and prevent conception in women for a long period. The aim of this study was to assess the influence of copper- versus levonorgestrel-releasing IUSs on women’s health. This is a descriptive cross-sectional study of 75 women that were randomly selected (50 women that used a copper-releasing IUS and the remaining 25 that used a levonorgestrel-releasing IUS) amongst those attending out patient’s clinics at Hillah, Iraq, from March to July 2016. All women were between 18 to 46 years of age, and have had an IUS for at least three months. The measurement of serum ceruloplasmin (SCerP), haemoglobin, vitamin D (VD), interleukin-6 (IL-6), and interferon-gamma (IFN-γ) levels was undertaken. Our results revealed that the copper-releasing IUS group has low haemoglobin and VD levels, along with high levels of SCerP and proinflammatory cytokines. One the other hand, the levonorgestrel-releasing IUS group displayed no significant changes on the above markers. We can conclude that the levonorgestrel-releasing IUS is free of any adverse effect when compared to a copper-releasing IUS, at least with regard to the parameters examined by our study.

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DOI: 10.61873/SUTM6297

Authors: Hayder Al-Hindy, Mazin Mousa, Muthanna Joudah

Abstract: Ceruloplasmin (CP) is an enzyme that has ferroxidase activity and is important in maintaining iron homeostasis and serving as a copper-transporter in the bloodstream. Beta-thalassemia major (BTM), a common hereditary disorder in Iraq, can affect CP activity in patients with iron overload resulting from frequent blood transfusions in order to sustain haemoglobin levels. The current study is a single-center observational research. CP activity was measured in 304 patients (120 females and 184 males). Anthropometric indices were recorded and the iron load status was determined by measuring serum ferritin. Ninety-two healthy individuals were also included as a control group. Our findings revealed no relationship between age, body mass index, or plasma ferritin and CP activity in BTM patients. No significant influence of sex on CP activity was observed. The outcomes provide insight into assumed pathways regulating CP, and add to the growing body of research on CP’s contribution to iron metabolism in BTM patients. To our knowledge, this work is the only study of its kind in Iraq, provides the groundwork for upcoming studies and potential therapeutic lines by generating insightful data on the multifaceted relationships between iron homeostasis, CP, and BTM.

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DOI: 10.61873/XRSQ1725

Authors: Hutham Abdulilah Amer Aladeli, Azhar Althahab, Sura I. A. Jabuk

Abstract: A total of 164 food samples were collected from various supermarkets and farmers in various areas of Babylon, were placed in plastic containers, and were transported to the laboratory. The isolation of Bacillus species was performed by culture in blood agar, chromogenic agar, and the absence of growth on McConkey agar, by staining with Gram stain, and through molecular identification of the species’ 16SrRNA gene and sequencing. The antibiotic susceptibility test used eight types of antibiotics. The undertaken sequencing identified the Bacillus isolates to belong to the following species: B. subtilis (2), B. cereus (6), B. thuringiensis (1), B. anthracis (1), and B. spizizenii (1). The susceptibility test of the six B. cereus isolates revealed that 5 (83.3%), 4 (66.6%), 3 (50%), 2 (33.3%), 2 (33.3%), 2 (33.3%), 1 (16.6%), and 0 (0%) were resistant to rifampicin, clindamycin, erythromycin, tetracycline, trimethoprim, nitrofurantoin, gentamicin, and ciprofloxacin, while the respective resistance numbers for the two isolates of B. subtilis were 2 (100%), 2 (100%), 2 (100%), 0 (0%), 1 (50%), 0 (0%), 0 (0%), and 0 (0%). One isolate of B. thuringiensis presented resistance to erythromycin, erythromycin, trimethoprim, and rifampicin, while one isolate of B. anthracis was found to be resistant to gentamicin, erythromycin, nitrofurantoin, and rifampicin. The B. spizizenii isolate was resistant to all antibiotics except gentamicin and trimethoprim.

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DOI: 10.61873/JYHN9753

Authors: Ali Kathem Ala Allah, shaimaa abd

Abstract: Azelnidipine is a calcium-channel antagonist classified as a “class 2” drug with high permeability and low aqueous solubility. It is used in the treatment of angina pectoris and hypertension without reflex tachycardia. Improvement of the solubility of azelnidipine and increasing drug’s bioavailability can be achieved through the drug encapsulation in solutol / D-α-tocopheryl polyethylene glycol succinate (TPGS) micelles. Six formulas were prepared by direct dissolution after using different amounts of solutol and TPGS. TPGS and solutol act as solubilizers, permeation enhancers, and P-glycoprotein inhibitors. The particle size, particle size distribution, zeta potential, and entrapment efficiency were determined. Depending on particle size and entrapment efficiency, formula #6 was selected and subjected to in vitro dilution stability and in vitro release studies. The results obtained showed that formula #6 was the best formula, with a high entrapment efficiency percentage equal to 86.5%±0.58% and a small particle size equal to 21.9±7.75 nm that did not change significantly after dilution up to 100-fold; a fact that reveals the high thermodynamic and kinetic stability of the optimum formula. The formula #6 release profile showed a controlled release of the drug from micelles when compared to plain drug release. Based on these results, polymeric nanomicelles are regarded as a promising delivery system for azelnidipine.

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DOI: 10.61873/ANKG7670

Authors: Rawaa Ahmed, Mohammed Ezzat

Abstract: Our study discusses the need for the development of alternative treatments for antiepileptic drugs. It proposes a theoretical chemical study using dioxoisoindoline derivatives and molecular docking in order to find potential alternative drugs. Three compounds (S1, S3, and S4) exhibited distinct activity against specific proteins related to epilepsy treatment. Our study also describes a DFT study that analysed the energy levels of the derivatives. Furthermore, we employed Lipinski’s rule and drug likeness predictions in order to assess the suitability of the derivatives as medicines. The results indicate that the molecular mass, log P, hydrogen bonding donors, and acceptors of the compounds fall within acceptable ranges. Overall, our study emphasizes the importance of finding new treatments for epilepsy, and presents a preliminary investigation into the potential of dioxoisoindoline derivatives.

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DOI: 10.61873/ONPK3289

Authors: Ghazwan Abdulhamza, Najeeb Mohammed

Abstract: Vasculopathy is typically seen in diabetic patients, and can lead to foot ulcerations. Carbon dioxide (CO 2 ) therapy was found to improve chronic wound healing in patients with vascular impairment. This type of therapy refers to the transcutaneous and subcutaneous application of CO 2 as well as CO 2 water baths for therapeutic purposes. In the method used herein, artificial CO 2 -containing water for foot bathing was generated by dissolving Carbothera® (MRE-SPA-MD; Mitsubishi Rayon Engineering, Tokyo, Japan) and generating CO 2 (free CO 2 concentration: 1,000–1,200 mg/L; pH 4.6). The foot of each patient was immersed in CO 2 -enriched water (depth of 20–30 cm, 37–38°C, 30-min duration) three times per week, for the next three months. Dramatic clinical improvement was observed in the CO 2 water bath therapy group before and after the treatment, while both the blood levels of the vascular endothelial growth factor and of the tumour necrosis factor-alpha in these patients exhibited significant changes. The advantages of this method are the absence of pain and the protection against infection, while the improved angiogenesis and oxygenation can result in healing of the chronic wound.

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DOI: 10.61873/SEXH5182

Authors: Noor Abdalwahd, Rafal Al-Saigh, Hussam Al-Humadi

Abstract: Invasive candidiasis associated with the dissemination of endogenous Candida species is a fatal condition linked to high rates of morbidity and mortality. Progressive drug resistance necessitates the need for prompt and effective therapy. Therefore, choosing a specific and effective treatment is crucial. A two-compartment in vitro pharmacokinetics (PK) / pharmacodynamics (PD) model has been used for this purpose, and the PD behaviours of amphotericin B (AMB; at 2.5 and 5 mg/L), voriconazole (VOR; at 1.5 and 3 mg/L), and itraconazole (ITR; at 1.5 and 3 mg/L) were assessed against two Candida albicans isolates (a sensitive and resistant one; ATCC-90028 and ATCC-10231, respectively) with or without the addition of human albumin (2%). PK were simulated as time-concentration profiles, while the PD susceptibility of all drug doses has been assessed through the minimum inhibitory concentration (MIC), the relative optical density of fungal growth, and the exposure – effect relationship (fAUC 0–24 /MIC). A fungicidal activity without the presence of albumin was seen against both isolates of C. albicans at the highest dose of VOR, while the addition of albumin potentiated the efficacies of AMB and of VOR against both isolates, with no effect for ITR. Finally, human albumin exerted a variable and dose-dependent effect on the activities of some antifungal agents.

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DOI: 10.61873/CNAY1739

Authors: Abdulazeez Basim A. Alhussein, Tayser Gaaz, Ahed Jaaz

Abstract: When nanotechnology is used in medicine, it makes it easier to find and treat a wide range of diseases. One of the oral options for treating multiple sclerosis (MS) is dimethyl fumarate (DMF). DMF has been shown to be effective in lowering inflammatory diseases; nevertheless, it is characterized by several undesirable side effects that reduce patient compliance and add financial obstacles. The aim of this study was to use platelet membranes and platelet nanoparticles to generate a drug delivery system that works like a cell, so as to treat MS. During the experiments, there is a chance that the DMF solution might harden at room temperature. Therefore, in order to produce solid lipid nanoparticles (SLNs), DMF was combined with biocompatible lipids. The creation of SLNs involved the use of hot emulsion and ultrasonication. These DMF-SLNs were characterized by means of scanning electron microscopy, and Fourier-transform infrared spectroscopy. The herein demonstrated enhanced qualities of the devised SLNs suggest that the formulation may be a potential, longer-acting formulation for the improved management of MS. SLNs could change the way many illnesses are treated in a big way, if they are used for the delivery of medicines.

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DOI: 10.61873/FKIQ6626

Authors: Maria Santos-Martinez

Abstract: Due to their unique physical and chemical properties, the potential application of nanomaterials in medicine is particularly attractive. Despite the many advantages that nanomaterials can offer as diagnostic and therapeutic tools, their transition from the bench to clinical practice is extremely challenging. One of the many barriers that nanomedicines may encounter is their toxicological effect. In fact, the development of novel nanomaterials / nanoparticles must proceed always in tandem with the assessment of any potential toxicological effects associated to them. Once nanomaterials reach the systemic circulation, they interact with endothelial cells, plasma proteins, and other blood components. There is no doubt that the study of nanomaterials-blood interactions is crucial to warrant the biocompatibility of nanomaterials developed for human use.

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DOI: 10.61873/VQJH7890

Authors: Fatima Mraiche

Abstract: Sodium-glucose cotransporter-2 (SGLT-2) inhibitors, approved for the treatment of diabetes mellitus, have gained attention for their cardioprotective effect. The exact mechanism by which SGLT-2 inhibitors exert their cardioprotective effect remains unclear. Recent studies have suggested that empagliflozin (EMPA), an SGLT inhibitor, exerts its cardioprotective effect by inhibiting the Na + /H + exchanger (NHE); a group of membrane proteins that regulate intracellular pH and cell volume. Increased activity and expression of NHE isoform 1 (NHE1), the predominant isoform expressed in the heart, leads to cardiac hypertrophy. Our research group investigates the indirect mechanisms by which SGLT inhibitors exert their cardioprotective effect and have demonstrated that angiotensin II (ANG)-induced hypertrophy of H9c2 cardiomyoblasts is accompanied with increased SGLT-1 and NHE1 protein expression; an effect which is reversed in the presence of EMPA. In addition, we demonstrated that dapagliflozin improved survival of transgenic mice expressing cardiac-specific NHE1.

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DOI: 10.61873/ZXQS4380

Authors: Junying Liu

Abstract: Network pharmacology as a “green approach”, predicting metabolite behaviours chemically and biologically and guiding biological experimental design, is a new strategy aiming to uncover the mechanism of action of natural products as drug candidates. It provides a powerful way to identify novel mechanisms of natural products with potential therapeutic effects. This approach has emerged as a powerful tool to overcome the limitations of traditional methods, such as the ability to predict the adverse effects of a drug and the likelihood of failure during clinical trials, by applying systems biology principles to the field of pharmacology. This method combines the multi-omics dataset, computer modeling, and chemical biology so as to reveal pharmaceutical actions and guide drug discovery. Therefore, computer-aided drug design combined with network pharmacology can be viewed as a novel in silico screening approach to drug discovery, by utilising chemoinformatics, bioinformatics, structure biology, and chemical biology. This strategy includes target-based virtual screening – molecular docking, ligand similarity-based virtual screening, and inverse screening (Inver-dock), providing a powerful tool for target identification of drug candidates, multitarget discovery, and natural bioactive product profiling. It can also be used for selectivity profiling of drugs, drug repositioning, safety profiling, and metabolism profiling prediction (ADMET).

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DOI: 10.61873/OVUE2319

Authors: Charis Liapi

Abstract: Proper nutrition helps protect from illness and disease. Choline (Ch), an essential molecule of substantial importance for the optimal development and function of several biological systems, plays a crucial role in the pathway of one-carbon metabolism. On the other hand, Ch-deprivation (CD) has been linked with abnormal fat metabolism, insulin resistance, and myocardial dysfunction. The Ch-deficiency setting is an established experimental model of non-alcoholic steatohepatitis that resembles the human non-alcoholic fatty liver disease (NAFLD); a disease with constantly increasing incidence and prevalence. NAFLD, commonly associated with metabolic comorbidities such as obesity and type 2 diabetes mellitus, consists a high risk for cardiovascular disease. Experimental data of dietary CD through the administration of a Ch-deficient diet to rodents have revealed myocardial monocyte infiltration along with cardiac interstitial oedema and fibrosis, as well as a deleterious effect on cardiac valves that could lead to impaired heart mechanical properties which resemble to a restrictive pattern of cardiomyopathy characterised mainly by diastolic dysfunction. In a Ch-deprived diabetic experimental model, the diastolic heart failure has been characterized by a concentric hypertrophied myocardium, a left ventricular cavity with a thinner wall, and an increased left ventricular diastolic diameter, in addition to a left atrial dilatation that could also exert functional derangement and provoke arrhythmogenesis, thereby jeopardising cardiac output.

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